Tag Archives: Calming Schools by Focusing on Well-Being of Troubled Students

University of Illinois Chicago study: One-third of US adults may unknowingly use medications that can cause depression

17 Jun

Moi said in Schools have to deal with depressed and troubled children:
Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.
As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Schools are developing strategies to deal with troubled kids.

Anna M. Phillips wrote the New York Times article, Calming Schools by Focusing on Well-Being of Troubled Students which describes how one New York school is dealing with its troubled children.

Mark Ossenheimer, principal of the Urban Assembly School for Wildlife Conservation in the Bronx, threw out a name to add to the list of teenagers in trouble.
Several teachers and a social worker seated around a table in the school’s cramped administrative offices nodded in agreement. They had watched the student, who had a housebound parent who was seriously ill, sink into heavy depression. Another child seemed to be moving from apartment to apartment, showing up at school only sporadically. And then there was the one grappling with gender-identity issues. Soon the list had a dozen names of students who could shatter a classroom’s composure or a school windowpane in a second.
Convening the meeting was Turnaround for Children, a nonprofit organization that the young-but-faltering school in an impoverished neighborhood near the Bronx Zoo had brought in this year to try to change things.
“This is the condition our organization was created to solve,” said Dr. Pamela Cantor, Turnaround’s founder and president. “A teacher who works in a community like this and thinks that these children can leave their issues at the door and come in and perform is dreaming.”
In focusing on students’ psychological and emotional well-being, in addition to academics, Turnaround occupies a middle ground between the educators and politicians who believe schools should be more like community centers, and the education-reform movement, with its no-excuses mantra. Over the past decade, the movement has argued that schools should concentrate on what high-quality, well-trained teachers can achieve in classrooms, rather than on the sociological challenges beyond their doors. http://www.nytimes.com/2011/11/15/nyregion/calming-schools-through-a-sociological-approach-to-troubled-students.html?hpw

One strategy in helping children to succeed is to recognize and treat depression. https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Science Daily reported in One-third of US adults may unknowingly use medications that can cause depression:

A new study from University of Illinois at Chicago researchers suggests that more than one-third of U.S. adults may be using prescription medications that have the potential to cause depression or increase the risk of suicide, and that because these medications are common and often have nothing to do with depression, patients and health care providers may be unaware of the risk.
The researchers retrospectively analyzed medication use patterns of more than 26,000 adults from 2005 to 2014, which were collected as part of the National Health and Nutrition Examination Survey. They found that more than 200 commonly used prescription drugs — including hormonal birth control medications, blood pressure and heart medications, proton pump inhibitors, antacids and painkillers — have depression or suicide listed as potential side effects.
Published in the Journal of the American Medical Association, the study is the first to demonstrate that these drugs were often used concurrently and that concurrent use, called polypharmacy, was associated with a greater likelihood of experiencing depression. Approximately 15 percent of adults who simultaneously used three or more of these medications experienced depression while taking the drugs, compared with just 5 percent for those not using any of the drugs, 7 percent for those using one medication and 9 percent for those taking two drugs simultaneously.
The researchers observed similar results for drugs that listed suicide as a potential side effect. These findings persisted when the researchers excluded anyone using psychotropic medications, considered an indicator of underlying depression unrelated to medication use.
“The take away message of this study is that polypharmacy can lead to depressive symptoms and that patients and health care providers need to be aware of the risk of depression that comes with all kinds of common prescription drugs — many of which are also available over the counter,” said lead author Dima Qato, assistant professor of pharmacy systems, outcomes and policy in the UIC College of Pharmacy. “Many may be surprised to learn that their medications, despite having nothing to do with mood or anxiety or any other condition normally associated with depression, can increase their risk of experiencing depressive symptoms, and may lead to a depression diagnosis.”
Qato notes that the study also shows an important trend of increasing polypharmacy for medications with depression, particularly suicidal symptoms, as a potential adverse effect. This makes the need for awareness of depression as a potential side effect even more pressing…. https://www.sciencedaily.com/releases/2018/06/180612185204.htm

Citation:

One-third of US adults may unknowingly use medications that can cause depression
Polypharmacy on the rise
Date: June 12, 2018
Source: University of Illinois at Chicago
Summary:
A new study suggests that more than one-third of U.S. adults may be using prescription medications that have the potential to cause depression or increase the risk of suicide.

Journal Reference:
1. Dima Mazen Qato, Katharine Ozenberger, Mark Olfson. Prevalence of Prescription Medications With Depression as a Potential Adverse Effect Among Adults in the United States. JAMA, 2018; 319 (22): 2289 DOI: 10.1001/jama.2018.6741

Here is the press release from University of Illinois Chicago:

One-third of US adults may unknowingly use medications that can cause depression
June 12, 2018
A new study from University of Illinois at Chicago researchers suggests that more than one-third of U.S. adults may be using prescription medications that have the potential to cause depression or increase the risk of suicide, and that because these medications are common and often have nothing to do with depression, patients and health care providers may be unaware of the risk.
The researchers retrospectively analyzed medication use patterns of more than 26,000 adults from 2005 to 2014, which were collected as part of the National Health and Nutrition Examination Survey. They found that more than 200 commonly used prescription drugs — including hormonal birth control medications, blood pressure and heart medications, proton pump inhibitors, antacids and painkillers — have depression or suicide listed as potential side effects.
Published in the Journal of the American Medical Association, the study is the first to demonstrate that these drugs were often used concurrently and that concurrent use, called polypharmacy, was associated with a greater likelihood of experiencing depression. Approximately 15 percent of adults who simultaneously used three or more of these medications experienced depression while taking the drugs, compared with just 5 percent for those not using any of the drugs, 7 percent for those using one medication and 9 percent for those taking two drugs simultaneously.
The researchers observed similar results for drugs that listed suicide as a potential side effect. These findings persisted when the researchers excluded anyone using psychotropic medications, considered an indicator of underlying depression unrelated to medication use.
“The take away message of this study is that polypharmacy can lead to depressive symptoms and that patients and health care providers need to be aware of the risk of depression that comes with all kinds of common prescription drugs — many of which are also available over the counter,” said lead author Dima Qato, assistant professor of pharmacy systems, outcomes and policy in the UIC College of Pharmacy. “Many may be surprised to learn that their medications, despite having nothing to do with mood or anxiety or any other condition normally associated with depression, can increase their risk of experiencing depressive symptoms, and may lead to a depression diagnosis.”
Qato notes that the study also shows an important trend of increasing polypharmacy for medications with depression, particularly suicidal symptoms, as a potential adverse effect. This makes the need for awareness of depression as a potential side effect even more pressing.
The researchers found use of any prescription medication with a potential depression adverse effect increased from 35 percent in the 2005 to 2006 period to 38 percent in the 2013 to 2014 period. Approximate use of antacids with potential depression adverse effects, like proton pump inhibitors and H2 antagonists, increased from 5 percent to 10 percent in the same period. Use of three or more drugs concurrently increased from 7 percent to 10 percent, approximately.
For prescription drugs with suicide listed as a potential side effect, usage increased from 17 percent to 24 percent, and use of three or more drugs concurrently increased from 2 percent to 3 percent.
“People are not only increasingly using these medicines alone, but are increasingly using them simultaneously, yet very few of these drugs have warning labels, so until we have public or system-level solutions, it is left up to patients and health care professionals to be aware of the risks,” Qato said.
Qato says that solutions worth further study may include updating drug safety software to recognize depression as a potential drug-drug interaction, so that health care professionals, including pharmacists, are more likely to notice if a patient is using multiple medications that may increase risk. Or, including evaluation of medication use in the depression screening and diagnostic tools used by doctors and nurses and recommended by the U.S. Preventive Services Task Force, especially when it comes to persistent or treatment-resistant depression.
“With depression as one of the leading causes of disability and increasing national suicide rates, we need to think innovatively about depression as a public health issue, and this study provides evidence that patterns of medication use should be considered in strategies that seek to eliminate, reduce or minimize the impact of depression in our daily lives,” Qato said.
Co-authors on the study are Katharine Ozenberger of UIC and Columbia University’s Mark Olfson. Qato and Olfson both noted financial disclosures potentially relevant to the study.
Contact
Jacqueline Carey
312-996-8277
jmcarey@uic.edu
twitter.com/JCareyUIC

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Related:

Schools have to deal with depressed and troubled children
https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children
https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’
https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:
1. About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

2. Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

3. Psychiatric News’ Study Helps Pinpoint Children With Depression http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

4. Family Doctor’s What Is Depression? http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

5. WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children

6. Healthline’s Is Your Child Depressed?
http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

7. Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Tulane University Medical School study: Family violence affects the DNA of children

17 Jun

Moi reported about the effect stress has on genes in Penn State study: Stress alters children’s genomes https://drwilda.com/2014/04/08/penn-state-study-stress-alters-childrens-genomes/ A Tulane Medical School study finds that family violence or trauma alters a child’s genomes.

Science Daily reported in the article, Family violence leaves genetic imprint on children:

A new Tulane University School of Medicine study finds that the more fractured families are by domestic violence or trauma, the more likely that children will bear the scars down to their DNA.
Researchers discovered that children in homes affected by domestic violence, suicide or the incarceration of a family member have significantly shorter telomeres, which is a cellular marker of aging, than those in stable households. The findings are published online in the latest issue of the journal Pediatrics.
Telomeres are the caps at the end of chromosomes that keep them from shrinking when cells replicate. Shorter telomeres are linked to higher risks for heart disease, obesity, cognitive decline, diabetes, mental illness and poor health outcomes in adulthood. Researchers took genetic samples from 80 children ages 5 to 15 in New Orleans and interviewed parents about their home environments and exposures to adverse life events….
The study found that gender moderated the impact of family instability. Traumatic family events were more detrimental to young girls as they were more likely to have shortened telomeres. There was also a surprising protective effect for boys: mothers who had achieved a higher level of education had a positive association with telomere length, but only in boys under 10.
Ultimately, the study suggests that the home environment is an important intervention target to reduce the biological impacts of adversity in the lives of young children, Drury said. http://www.sciencedaily.com/releases/2014/06/140617102505.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily%2Ftop_news%2Ftop_science+%28ScienceDaily%3A+Top+Science+News%29&utm_content=FaceBook

Citation:

Family violence leaves genetic imprint on children
Date: June 17, 2014
Source: Tulane University
Summary:
Children in homes affected by violence, suicide, or the incarceration of a family member have significantly shorter telomeres -— a cellular marker of aging — than those in stable households. The study suggests that the home environment is an important intervention target to reduce the biological impacts of adversity in the lives of young children.
Journal Reference:
1. S. S. Drury, E. Mabile, Z. H. Brett, K. Esteves, E. Jones, E. A. Shirtcliff, K. P. Theall. The Association of Telomere Length With Family Violence and Disruption. PEDIATRICS, 2014; 134 (1): e128 DOI: 10.1542/peds.2013-3415

Here is the press release from Tulane University:

Study: Family violence leaves genetic imprint on children
June 16, 2014
Keith Brannon
Phone: 504-862-8789

kbrannon@tulane.edu
A new Tulane University School of Medicine study finds that the more fractured families are by domestic violence or trauma, the more likely that children will bear the scars down to their DNA.
Researchers discovered that children in homes affected by domestic violence, suicide or the incarceration of a family member have significantly shorter telomeres, which is a cellular marker of aging, than those in stable households. The findings are published online in the latest issue of the journal Pediatrics.
Telomeres are the caps at the end of chromosomes that keep them from shrinking when cells replicate. Shorter telomeres are linked to higher risks for heart disease, obesity, cognitive decline, diabetes, mental illness and poor health outcomes in adulthood. Researchers took genetic samples from 80 children ages 5 to 15 in New Orleans and interviewed parents about their home environments and exposures to adverse life events.
“Family-level stressors, such as witnessing a family member get hurt, created an environment that affected the DNA within the cells of the children,” said lead author Dr. Stacy Drury, director of the Behavioral and Neurodevelopmental Genetics Laboratory at Tulane. “The greater the number of exposures these kids had in life, the shorter their telomeres were – and this was after controlling for many other factors, including socioeconomic status, maternal education, parental age and the child’s age.”
The study found that gender moderated the impact of family instability. Traumatic family events were more detrimental to young girls as they were more likely to have shortened telomeres. There was also a surprising protective effect for boys: mothers who had achieved a higher level of education had a positive association with telomere length, but only in boys under 10.
Ultimately, the study suggests that the home environment is an important intervention target to reduce the biological impacts of adversity in the lives of young children, Drury said.

See, School psychologists are needed to treat troubled children https://drwilda.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Our goal as a society should be:
A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Related:

Schools have to deal with depressed and troubled children https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’ https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:

About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psychiatric News’ Study Helps Pinpoint Children With Depression
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

Family Doctor’s What Is Depression? http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children

Healthline’s Is Your Child Depressed? http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com

Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda © https://drwilda.com/

‘Peer Counseling’ in schools

28 Apr

Moi wrote about a high school support program in Helping troubled children: The ‘Reconnecting Youth Program’:
Many children arrive at school with mental health and social issues. In School psychologists are needed to treat troubled children:

Mark Phillips, professor emeritus of secondary education at San Francisco State University wrote the article, School psychologists: Shortage amid increased need which discusses the need for psychological support in schools.
The adolescent suicide rate continues to rise, with each suicide a dramatic reminder that the lives of a significant number of adolescents are filled with anxiety and stress. Most schools have more than a handful of kids wrestling with significant emotional problems, and schools at all levels face an ongoing challenge related to school violence and bullying, both physical and emotional.
Yet in many schools there is inadequate professional psychological support for students.
Although statistics indicate that there is a significant variation from state to state (between 2005- and 2011 the ratio of students per school psychologist in New Mexico increased by 180%, while in the same period the ratio decreased in Utah by 34%), the overall ratio is 457:1. That is almost twice that recommended by the National Association of School Psychologists (NASP).
THE NASP noted a shortage of almost 9,000 school psychologists in 2010 and projected a cumulative shortage of close to 15,000 by 2020. Mental Health America estimates that only 1 in 5 children in need of mental health services actually receive the needed services. These gross statistics also omit the special need of under funded schools and the increased roles school psychologists are being asked to play….
Even with the psychological services that should be provided and often aren’t, schools can’t fully prevent suicides, acts of violence, bullying, or the daily stresses that weigh on kids shoulders. The malaise runs deeper and broader.
Still schools need more resources than they receive in order to provide more programs that actively identify and counsel those kids that need help. At the very least, they need to alleviate some of the stress these kids are experiencing and to help improve the quality of their daily lives. http://www.washingtonpost.com/blogs/answer-sheet/post/school-psychologists-shortage-amid-increased-need/2012/02/26/gIQAU7psdR_blog.html

It is important to deal with the psychological needs of children because untreated depression can lead to suicide. https://drwilda.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/ In addition to psychological programs, schools can offer other resources to help students succeed in school and in life.

Rebecca Jones of Ed News Colorado wrote about the Reconnecting Youth Program in the article, Reconnecting Youth program boosts teens.
http://www.ednewscolorado.org/2012/10/30/51106-reconnecting-youth-program-boosts-teens https://drwilda.com/2012/10/30/helping-troubled-children-the-reconnecting-youth-program/
Another model many schools are trying is peer counseling.

Evie Blad reported in the Education Week article, Schools Explore Benefits of Peer Counseling about peer counseling:

Schools in Baltimore, New York City, New Jersey, and North Carolina have used the program—created by the Princeton, N.J.-based Center for Supportive Schools—to boost attendance, academic persistence, and graduation rates.
At a time when schools are increasingly recognizing the important role social and emotional factors can play in academic success, leaders are wasting a valuable resource if they don’t enlist energetic students to help their peers, said Daniel F. Oscar, the president and chief executive officer of the Center for Supportive Schools.
“It becomes a very positive feedback loop where, by the act of helping the school out, that older student is in fact deepening his or her own education,” Mr. Oscar said. “Leadership is increasingly something that we don’t only expect from the person who has the top title in an organization. It’s something we expect from everyone.”
A study by researchers at Rutgers University in New Brunswick, N.J. published in the Journal of Educational Research found that Peer Group Connection had notable success raising graduation rates for Latino males.
Promising Signs
In a randomized control study, researchers tracked four-year graduation rates for 268 participating students at a high-poverty, mid-Atlantic, urban high school that is not named in the study. Of the program’s participants, 77 percent graduated high school in four years, compared with 68 percent of their nonparticipating peers. Latino males in the experimental group had an 81 percent graduation rate, compared to 63 percent in the control group.
Peer Group Connection is more successful than some other peer-mentoring efforts because it is integrated into the school day, incorporates several meetings with students’ families to reinforce lessons and supports, and requires buy-in from principals and teachers before a school implements the program, the researchers wrote.
The program employs a “train the trainer” model under which juniors and seniors complete a yearlong, credit-bearing leadership course where they practice group exercises and discussions. Older students also meet once a week with younger students to complete the exercises they practiced in class.
The class is led by teachers who received extensive training on the program, primarily through an 11-day course and a retreat with Center for Supportive Schools staff.
That training helps prepare teachers for a level of honesty they might not typically experience with students, said Sherry Barr, the vice president of the organization.
“When they go through it themselves and experience what it means to them to break down some of those barriers, that’s a very powerful experience,” Ms. Barr said. “They sort of leave transformed in the sense that they really want to have that experience with their students.”
As those teachers work with peer mentors in training, those discussions—often centered on experiences that can form hurdles for school completion and persistence—can be emotional.
On an April afternoon in Baltimore, peer leaders at the Academy for College and Career Exploration practiced how they would react to various text messages from peers, including nude photos and an angry message from a friend. Would they forward the photos to others? Would they respond to anger with anger?
“Keep it real,” teacher Candice Boone told senior Jada Davis, urging her to avoid simply telling adults in the room what she thought they’d want to hear about how she would respond to the hypothetical angry text message.
“You know I am,” Ms. Davis said, admitting that she “most likely would be going back and forth” with her friend if she got such a message.
Students also discussed the way girls are bullied and teased if they send a nude photo to a boyfriend, only to have it circulating on social media the next day. It’s a side of students teachers don’t always see, Ms. Boone said…. http://www.edweek.org/ew/articles/2014/04/23/29peerconnection.h33.html

The Center for Supportive Schools is one of the primary providers of training for peer counselors.

Here is what the Center for Supportive Schools says about Peer Counseling.

Peer Group Connection (PGC)
Through Peer Group Connection (PGC), CSS trains school faculty to teach leadership courses to select groups of older students, who in turn educate and support younger students. Our goal is to help schools enable and inspire young people to become engaged leaders who positively influence their peers. The CSS peer-to-peer student leadership model taps into schools’ most underutilized resources – students – and enlists them in strengthening the educational offerings of a school while simultaneously advancing their own learning, growth, and development.
Transition to High School
High School Juniors and Seniors Supporting Freshmen in Their Transition to High School
Peer Group Connection (PGC) for High Schools is an evidence-based program that supports and eases students’ successful transition from middle to high school. The program taps into the power of high school juniors and seniors to create a nurturing environment for incoming freshmen. Once per week, pairs of junior and senior peer leaders meet with groups of 10-14 freshmen in outreach sessions designed to strengthen relationships among students across grades. These peer leaders are simultaneously enrolled in a daily, for-credit, year-long leadership course taught by school faculty during regular school hours. PGC is CSS’s seminal peer leadership program, and has been implemented with a 70% sustainability rate in more than 175 high schools since 1979. A recently released, four-year longitudinal, randomized-control study conducted by Rutgers University and funded by the United States Department of Health and Human Services found that, among other major results, PGC improves the graduation rates of student participants in an inner city public school by ten percentage points and cuts by half the number of male students who would otherwise drop out.
http://supportiveschools.org/solutions/peer-group-connection/

Not all are supportive of peer counseling.

Andrew S. Latham wrote in the 1997 Education Leadership article, Research Link / Peer Counseling Proceed with Caution:

One of Lewis and Lewis’s concerns is that students serving as peer counselors are increasingly being asked to shoulder a burden that should be overseen only by trained, seasoned professionals. In a sobering study, the two researchers compared suicide rates among schools with no peer-led suicide-prevention program; schools with peer-led prevention programs overseen by a noncounselor (for example, a teacher or building administrator); and schools with peer-led prevention programs overseen by a certified counselor, psychologist, or social worker. Shockingly, the 38 schools with the noncounselor-led peer programs had the highest ratio of student suicides: Between 1991 and 1993, 11 of those 38 schools (29 percent) reported at least one suicide, as opposed to 7 of 55 schools (13 percent) with no prevention program at all, and just 5 of 65 schools (8 percent) with a counselor-led peer program….
Although Lewis and Lewis focus on suicide-prevention programs, we can extend this argument to other health and safety issues teens face, such as AIDS and drug and alcohol abuse. As teens confront the problems of the 1990s, they want concrete advice, not just an empathetic listener. Morey and colleagues (1993) confirmed this fact when they used a stepwise regression to identify factors that contribute to students’ satisfaction with peer counseling. Two such factors were “empathy and problem identification” and “empathy and problem solving,” indicating that students want help from peers who are willing to listen and understand their problems, and who can suggest ways to address those problems.
Professional Support Is Critical
These studies point to the need for students to receive extensive training and professional support both before and throughout their work with their peers. If such support is given, peer programs have tremendous potential.
A case in point: O’Hara and colleagues (1996) studied the effects of a student-led AIDS prevention program in an alternative school for at-risk youth. Following an initial interview, the peer counselors were trained over the course of eight weeks, including five classroom sessions, two retreats, and a trip to a local clinic for sexually transmitted diseases. Peer counselors with attendance problems were dropped from the program. Those who successfully completed the program then conducted two carefully structured large-group sessions with their peers, followed by two small-group sessions and various schoolwide activities. The results were impressive: pre- and post-intervention student surveys revealed that the number of students who intended to use condoms each time they had sex rose from 55 to 65 percent, while those reporting they had never used a condom dropped from 15 to 4 percent.
The lesson from these examples is that peer-led programs must be adopted carefully, particularly when dealing with the high-stakes problems that many teenagers face today. In fact, professional intervention may be preferable to peer support for potentially lethal issues, such as teen suicide…. http://www.ascd.org/publications/educational-leadership/oct97/vol55/num02/Peer-Counseling@-Proceed-with-Caution.aspx

For research on peer counseling programs, see http://www.cde.ca.gov/ls/cg/rh/counseffective.asp

Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Related:

Schools have to deal with depressed and troubled children
https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children
https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’
https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda © https://drwilda.com/

‘Mental Health First Aid’ helps schools reach out to troubled kids

22 Apr

Anna M. Phillips has wrote the New York Times article, Calming Schools by Focusing on Well-Being of Troubled Students which describes how one New York school is dealing with its troubled children.

Mark Ossenheimer, principal of the Urban Assembly School for Wildlife Conservation in the Bronx, threw out a name to add to the list of teenagers in trouble.
Several teachers and a social worker seated around a table in the school’s cramped administrative offices nodded in agreement. They had watched the student, who had a housebound parent who was seriously ill, sink into heavy depression. Another child seemed to be moving from apartment to apartment, showing up at school only sporadically. And then there was the one grappling with gender-identity issues. Soon the list had a dozen names of students who could shatter a classroom’s composure or a school windowpane in a second.
Convening the meeting was Turnaround for Children, a nonprofit organization that the young-but-faltering school in an impoverished neighborhood near the Bronx Zoo had brought in this year to try to change things.
“This is the condition our organization was created to solve,” said Dr. Pamela Cantor, Turnaround’s founder and president. “A teacher who works in a community like this and thinks that these children can leave their issues at the door and come in and perform is dreaming.”
In focusing on students’ psychological and emotional well-being, in addition to academics, Turnaround occupies a middle ground between the educators and politicians who believe schools should be more like community centers, and the education-reform movement, with its no-excuses mantra. Over the past decade, the movement has argued that schools should concentrate on what high-quality, well-trained teachers can achieve in classrooms, rather than on the sociological challenges beyond their doors.
http://www.nytimes.com/2011/11/15/nyregion/calming-schools-through-a-sociological-approach-to-troubled-students.html?hpw

One strategy in helping children to succeed is to recognize and treat depression.

How Common Is Depression In Children?

According to Mary H. Sarafolean, PhD, in the article, Depression In School Age Children and Adolescents:

In general, depression affects a person’s physical, cognitive, emotional/affective, and motivational well-being, no matter their age. For example, a child with depression between the ages of 6 and 12 may exhibit fatigue, difficulty with schoolwork, apathy and/or a lack of motivation. An adolescent or teen may be oversleeping, socially isolated, acting out in self-destructive ways and/or have a sense of hopelessness.
Prevalence and Risk Factors
While only 2 percent of pre-teen school-age children and 3-5 percent of teenagers have clinical depression, it is the most common diagnosis of children in a clinical setting (40-50 percent of diagnoses). The lifetime risk of depression in females is 10-25 percent and in males, 5-12 percent. Children and teens who are considered at high risk for depression disorders include:
* children referred to a mental health provider for school problems
* children with medical problems
* gay and lesbian adolescents
* rural vs. urban adolescents
* incarcerated adolescents
* pregnant adolescents
* children with a family history of depression

If you or your child has one or more of the risk factors and your child is exhibiting symptoms of prolonged sadness, it might be wise to have your child evaluated for depression.

How to Recognize Depression In Your Child?

MedNet has an excellent article about Depression In Children and how to recognize signs of depression in your child.

Signs and symptoms of depression in children include:
* Irritability or anger
* Continuous feelings of sadness, hopelessness
* Social withdrawal
* Increased sensitivity to rejection
* Changes in appetite — either increased or decreased
* Changes in sleep — sleeplessness or excessive sleep
* Vocal outbursts or crying
* Difficulty concentrating
* Fatigue and low energy
* Physical complaints (such as stomachaches, headaches) that do not respond to
treatment
* Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
* Feelings of worthlessness or guilt
* Impaired thinking or concentration
* Thoughts of death or suicide
Not all children have all of these symptoms. In fact, most will display different symptoms at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance. Children may also begin using drugs or alcohol,
especially if they are over the age of 12.

The best defense for parents is a good awareness of what is going on with their child. As a parent you need to know what is going on in your child’s world.

Ann Schimke posted at Chalkbeat Colorado in the article, A new tool in schools’ mental health tool box which describes Mental Health First Aid:

Called Youth Mental Health First Aid, the training originated in Australia and was unveiled in Colorado last year. There is also an adult version of the training, introduced here in 2008, called Mental Health First Aid or MHFA.
Both are gaining momentum in what mental health advocates say is a welcome development in a state saddled with one of the highest suicide rates in the country and more than its fair share of school tragedies, including a deadly shooting at Centennial’s Arapahoe High School in December and a self-immolation at Westminster’s Standley Lake High School in January.
Olga Gonzalez, a community outreach worker who participated in the recent Greeley training, said she regularly fields questions from parents who are worried about their children but don’ t know where to turn. She recounted how one family she’d worked with discovered their son had started using drugs. Another learned that their son had stolen credit card information from a customer while manning the cash register at the family’s store.
“He has money in a savings account, you know. He just did it,” she said. “I wasn’t sure what kind of support he needs.”
Youth Mental Health First Aid aims to answer such questions for people who are not mental health professionals but who work closely with young people and their families. The target audience includes lay-people like teachers, coaches, guidance counselors, school nurses and even bus drivers.
Advocates for MHFA say Colorado now has one of the largest contingents of certified instructors—around 230 so far. In addition, it’s among only a handful of states to dedicate public funds to the trainings, with $750,000 appropriated for the program next year.
“We have been at the forefront of this since the beginning,” said Brian Turner, director of Mental Health First Aid Colorado at the Colorado Behavioral Healthcare Council.
Preparing first responders
The concept behind both versions of MHFA, much like medical first-aid, is to equip first responders with the know-how to address emerging mental health or addiction problems. The youth version is also meant to help distinguish between true mental health issues and the normal mood swings and behavior changes that characterize the life of a teenager…
In fact, encouraging youth to seek professional help is one of five action steps—condensed in the acronym ALGEE–outlined in the training. The other four include “Assess for suicide/self harm,” “Listen non-judgmentally,” “Give assurance/information,” and “Encourage self-help/other support.”
Turner said having concrete action steps is important because “there’s a big difference between learning about mental health and substance abuse problems and being able to do something about it.”
During the Greeley training, participants were asked to come up with gestures that would convey each of the five action steps. Soon, in an effort to commit the steps to memory, Vaughn and co-trainer Noelle Hause were leading the group in miming actions like non-judgmental head-nodding and reassuring arm-patting.
Reaching out to schools
While Turner said Youth Mental Health First Aid is not yet widely offered by school districts, there is growing interest. Among the districts that have offered it for at least some staff are Douglas County, Aurora, Thompson, and Weld County District 6.
Barb Becker, division director for community programs at the Arapahoe/Douglas Mental Health Network, said the one-day format make it a very doable training for educators.
“It just gives a really good overview,” she said, adding, “It takes away some of the stigma associated with mental health….” http://co.chalkbeat.org/2014/04/16/a-new-tool-in-schools-mental-health-tool-box/

Here is a description of Mental Health First Aid:

Mental Health First Aid is an 8-hour course that teaches you how to help someone who is developing a mental health problem or experiencing a mental health crisis. The training helps you identify, understand, and respond to signs of mental illnesses and substance use disorders.
History

Tony Jorm and Betty Kitchener.
Mental Health First Aid was created in 2001 by Betty Kitchener, a nurse specializing in health education, and Anthony Jorm, a mental health literacy professor. Kitchener and Jorm run Mental Health First Aid™ Australia, a national non-profit health promotion charity focused on training and research. More information on the history of the course is available at Mental Health First Aid Australia.
The United States is just one of the many countries that have adapted the program from Australia. Check out the countries at Mental Health First Aid International.
Who We Are
Mental Health First Aid USA is coordinated by the National Council for Behavioral Health, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health. In 2008, we worked with the program’s founders to adapt Mental Health First Aid for the U.S. We ensure the quality and standardization of the program nationwide, certify instructors to teach Mental Health First Aid in local communities, and support program growth. http://www.mentalhealthfirstaid.org/cs/about/

Here is The National Registry of Evidence-based Programs and Practices (NREPP) review of Mental Health First Aid.

Intervention Summary
Mental Health First Aid
Mental Health First Aid is an adult public education program designed to improve participants’ knowledge and modify their attitudes and perceptions about mental health and related issues, including how to respond to individuals who are experiencing one or more acute mental health crises (i.e., suicidal thoughts and/or behavior, acute stress reaction, panic attacks, and/or acute psychotic behavior) or are in the early stages of one or more chronic mental health problems (i.e., depressive, anxiety, and/or psychotic disorders, which may occur with substance abuse).
The intervention is delivered by a trained, certified instructor through an interactive 12-hour course, which can be completed in two 6-hour sessions or four 3-hour sessions. The course introduces participants to risk factors, warning signs, and symptoms for a range of mental health problems, including comorbidity with substance use disorders; builds participants’ understanding of the impact and prevalence of mental health problems; and provides an overview of common support and treatment resources for those with a mental health problem. Participants also are taught a five-step action plan, known as ALGEE, for use when providing Mental Health First Aid to an individual in crisis:
• A–Assess for risk of suicide or harm
• L–Listen nonjudgmentally
• G–Give reassurance and information
• E–Encourage appropriate professional help
• E–Encourage self-help and other support strategies
In addition, the course helps participants to not only gain confidence in their capacity to approach and offer assistance to others, but also to improve their personal mental health. After completing the course and passing an examination, participants are certified for 3 years as a Mental Health First Aider.
In the studies reviewed for this summary, Mental Health First Aid was delivered as a 9-hour course, through three weekly sessions of 3 hours each. Participants were recruited from community and workplace settings in Australia or were members of the general public who responded to recruitment efforts. Some of the participants (7%-60% across the three studies reviewed) had experienced mental health problems.

Descriptive Information
Areas of Interest Mental health promotion
Outcomes Review Date: May 2012
1: Recognition of schizophrenia and depression symptoms
2: Knowledge of mental health support and treatment resources
3: Attitudes about social distance from individuals with mental health problems
4: Confidence in providing help, and provision of help, to an individual with mental health problems
5: Mental health
Outcome Categories Mental health
Social functioning
Ages 18-25 (Young adult)
26-55 (Adult)
55+ (Older adult)
Genders Male
Female
Races/Ethnicities Non-U.S. population
Settings Workplace
Other community settings
Geographic Locations Urban
Suburban
Rural and/or frontier
Implementation History Mental Health First Aid was developed in 2001 at the Australian National University. The program was first used in the United States in 2007, and since then, the program has trained over 1,500 instructors in 45 States, the District of Columbia, and Puerto Rico. These instructors have taught the course to more than 38,000 people in a variety of communities. The program has been implemented internationally in Australia, Cambodia, China, England, Finland, Hong Kong, Ireland, Japan, Nepal, New Zealand, Scotland, Singapore, South Africa, Sweden, Thailand, and Wales.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations Mental Health First Aid has been adapted for youth participants (i.e., those under age 18), using age-appropriate examples and format. The program has been translated into Vietnamese for use in Vietnamese communities in Australia.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal
Selective
Indicated
Learn More – Click on each category bar below or the buttons at the right to expand or collapse the sections.
http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=321

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Related:

GAO report: Children’s mental health services are lacking https://drwilda.com/2013/01/12/gao-report-childrens-mental-health-services-are-lacking/

Schools have to deal with depressed and troubled children https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

University of Cambridge study: Saliva test may detect depression in kids https://drwilda.com/2014/02/23/university-of-cambridge-study-saliva-test-may-detect-depression-in-kids/

Study: Some of the effects of adverse stress do not go away https://drwilda.com/2012/11/09/study-some-of-the-effects-of-adverse-stress-do-not-go-away/

American Psychological Association: Kids too stressed out to be healthy https://drwilda.com/2014/02/12/american-psychological-association-kids-too-stressed-out-to-be-healthy/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda © https://drwilda.com/

Penn State study: Stress alters children’s genomes

8 Apr

Moi said in Schools have to deal with depressed and troubled children:
Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.
As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Schools are developing strategies to deal with troubled kids.

Jyoti Madhusoodanan and Nature magazine reported in the Scientific American article, Stress Alters Children’s Genomes:

Growing up in a stressful social environment leaves lasting marks on young chromosomes, a study of African American boys has revealed. Telomeres, repetitive DNA sequences that protect the ends of chromosomes from fraying over time, are shorter in children from poor and unstable homes than in children from more nurturing families.
When researchers examined the DNA of 40 boys from major US cities at age 9, they found that the telomeres of children from harsh home environments were 19% shorter than those of children from advantaged backgrounds. The length of telomeres is often considered to be a biomarker of chronic stress.
The study, published today in the Proceedings of the National Academy of Sciences, brings researchers closer to understanding how social conditions in childhood can influence long-term health, says Elissa Epel, a health psychologist at the University of California, San Francisco, who was not involved in the research.
Participants’ DNA samples and socio-economic data were collected as part of the Fragile Families and Child Wellbeing Study, an effort funded by the National Institutes of Health to track nearly 5,000 children, the majority of whom were born to unmarried parents in large US cities in 1998–2000. Children’s environments were rated on the basis of their mother’s level of education; the ratio of a family’s income to needs; harsh parenting; and whether family structure was stable, says lead author Daniel Notterman, a molecular biologist at Pennsylvania State University in Hershey.
The telomeres of boys whose mothers had a high-school diploma were 32% longer compared with those of boys whose mothers had not finished high school. Children who came from stable families had telomeres that were 40% longer than those of children who had experienced many changes in family structure, such as a parent with multiple partners.
Genetic links
The link between stressful home environments and telomere length is moderated by genetic variants in pathways that process two chemical transmitters in the brain, serotonin and dopamine, the study found. Previous studies have correlated variants in some of the genes studied, such as TPH2, with depression, bipolar disorder and other mental-health issues. Variants of another gene, 5-HTT, reduce the amount of the protein that recycles serotonin in nerve synapses. Some alleles of these genes are thought to increase the sensitivity of carriers to external risks…. http://www.scientificamerican.com/article/stress-alters-childrens-genomes/?WT.mc_id=SA_Facebook

Citation:

Social disadvantage, genetic sensitivity, and children’s telomere length
1. Colter Mitchella,
2. John Hobcraftb,
3. Sara S. McLanahanc,1,
4. Susan Rutherford Siegeld,
5. Arthur Bergd,
6. Jeanne Brooks-Gunne,
7. Irwin Garfinkelf, and
8. Daniel Nottermand,g,1
Author Affiliations
Significance
This paper makes two contributions to research on the link between the social environment and health. Using data from a birth cohort study, we show that, among African American boys, those who grow up in highly disadvantaged environments have shorter telomeres (at age 9) than boys who grow up in highly advantaged environments. We also find that the association between the social environment and telomere length (TL) is moderated by genetic variation within the serotonin and dopamine pathways. Boys with the highest genetic sensitivity scores had the shortest TL when exposed to disadvantaged environments and the longest TL when exposed to advantaged environments. To our knowledge, this report is the first to document a gene–social environment interaction for TL, a biomarker of stress exposure.
Abstract
Disadvantaged social environments are associated with adverse health outcomes. This has been attributed, in part, to chronic stress. Telomere length (TL) has been used as a biomarker of chronic stress: TL is shorter in adults in a variety of contexts, including disadvantaged social standing and depression. We use data from 40, 9-y-old boys participating in the Fragile Families and Child Wellbeing Study to extend this observation to African American children. We report that exposure to disadvantaged environments is associated with reduced TL by age 9 y. We document significant associations between low income, low maternal education, unstable family structure, and harsh parenting and TL. These effects were moderated by genetic variants in serotonergic and dopaminergic pathways. Consistent with the differential susceptibility hypothesis, subjects with the highest genetic sensitivity scores had the shortest TL when exposed to disadvantaged social environments and the longest TL when exposed to advantaged environments.
gene–environment
adversity
senescence
Footnotes
↵1To whom correspondence may be addressed. E-mail: dan1@princeton.edu or mclanaha@princeton.edu.
Author contributions: C.M., J.H., S.S.M., J.B.-G., I.G., and D.N. designed research; C.M., J.H., S.S.M., J.B.-G., I.G., and D.N. performed research; S.R.S. and D.N. contributed new reagents/analytic tools; C.M., J.H., S.S.M., A.B., J.B.-G., I.G., and D.N. analyzed data; and C.M. and D.N. wrote the paper.
Reviewers: T.E.S., Geffen School of Medicine, University of California, Los Angeles; S.J.S., Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.
The authors declare no conflict of interest.
This article contains supporting information online at http://www.pnas.org/lookup/suppl/doi:10.1073/pnas.1404293111/-/DCSupplemental.
Freely available online through the PNAS open access option.

Here is the press release from Penn State:

Disadvantaged environments affect genetic material, study finds
By Scott Gilbert
April 8, 2014
HERSHEY, Pa. — Children experiencing chronic stress from a disadvantaged life have shorter telomeres than their advantaged peers, according to a study led by Dr. Daniel Notterman, vice dean for research and graduate studies, and professor of pediatrics, and biochemistry and molecular biology at Penn State College of Medicine.
Telomeres are DNA sequences at the end of each chromosome that protect the ends of the chromosomes from damage. They vary in length per person and shrink as a person ages, a process that may be linked to health and disease.
The negative health effects of long-term chronic stress may be connected to the shortening of telomeres. Telomeres shorten faster in individuals experiencing chronic stress, such as that from living in a disadvantaged environment.
Notterman and colleagues studied genetic information from 40 9-year-old African-American boys.
Boys from disadvantaged environments had shorter telomeres than peers in the study who were not. In addition, the effect of environment on telomere length was mediated by genes involved with the function of two neurotransmitters, dopamine and serotonin. Neurotransmitters help transmit signals between brain cells and send information throughout the body.
For boys with genetic variants of dopamine or serotonin pathways that conferred greater sensitivity to environmental signals associated with stress, those from disadvantaged environments had the shortest telomeres, and those from advantaged environments had the longest.
The results suggest a link between genetic factors and social environment associated with changing telomere length and provides a biomarker for chronic stress exposure in children as young as 9, according to the authors.
Researchers also from Penn State College of Medicine are Arthur Berg, associate professor of biostatistics and bioinformatics, and Sue Siegel, assistant professor of biochemistry and molecular biology.
The study is published in Proceedings of the National Academy of Sciences (PNAS) and was supported by the National Institutes of Health-National Institute of Child Health and Human Development, and the Penn State Clinical and Translational Science Institute. For more information, visit PNAS’s Early Edition.
Sarah D. Sparks writes in the Education Week article, Research Traces Impacts of Childhood Adversity:
The stress of a spelling bee or a challenging science project can enhance a student’s focus and promote learning. But the stress of a dysfunctional or unstable home life can poison a child’s cognitive ability for a lifetime, according to new research.
While educators and psychologists have said for decades that the effects of poverty interfere with students’ academic achievement, new evidence from cognitive and neuroscience is showing exactly how adversity in childhood damages students’ long-term learning and health….
Good experiences, like nurturing parents and rich early-child-care environments, help build and reinforce neural connections in areas such as language development and self-control, while adversity weakens those connections.
Over time, the connections, good or bad, stabilize, “and you can’t go back and rewire; you have to adapt,” Dr. Shonkoff said. “If you’ve built on strong foundations, that’s good, and if you have weak foundations, the brain has to work harder, and it costs more to the brain and society…”
The Centers for Disease Control and Prevention provides access to the peer-reviewed publications resulting from The ACE Study. http://acestudy.org/

See, School psychologists are needed to treat troubled children https://drwilda.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Related:

Schools have to deal with depressed and troubled children
https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children
https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’
https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:
1. About.Com’s Depression In Young Children
http://depression.about.com/od/child/Young_Children.htm

2. Psych Central’s Depression In Young Children
http://depression.about.com/od/child/Young_Children.htm

3. Psychiatric News’ Study Helps Pinpoint Children With Depression http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

4. Family Doctor’s What Is Depression?
http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

5. WebMD’s Depression In Children
http://www.webmd.com/depression/guide/depression-children

6. Healthline’s Is Your Child Depressed?
http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

7. Medicine.Net’s Depression In Children
http://www.onhealth.com/depression_in_children/article.htm

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com
Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda © https://drwilda.com/

University of Cambridge study: Saliva test may detect depression in kids

23 Feb

Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.
As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8.
http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Schools are developing strategies to deal with troubled kids.

Anna M. Phillips wrote the New York Times article, Calming Schools by Focusing on Well-Being of Troubled Students which describes how one New York school is dealing with its troubled children.

>Mark Ossenheimer, principal of the Urban Assembly School for Wildlife Conservation in the Bronx, threw out a name to add to the list of teenagers in trouble.
Several teachers and a social worker seated around a table in the school’s cramped administrative offices nodded in agreement. They had watched the student, who had a housebound parent who was seriously ill, sink into heavy depression. Another child seemed to be moving from apartment to apartment, showing up at school only sporadically. And then there was the one grappling with gender-identity issues. Soon the list had a dozen names of students who could shatter a classroom’s composure or a school windowpane in a second.
Convening the meeting was Turnaround for Children, a nonprofit organization that the young-but-faltering school in an impoverished neighborhood near the Bronx Zoo had brought in this year to try to change things.
“This is the condition our organization was created to solve,” said Dr. Pamela Cantor, Turnaround’s founder and president. “A teacher who works in a community like this and thinks that these children can leave their issues at the door and come in and perform is dreaming.”
In focusing on students’ psychological and emotional well-being, in addition to academics, Turnaround occupies a middle ground between the educators and politicians who believe schools should be more like community centers, and the education-reform movement, with its no-excuses mantra. Over the past decade, the movement has argued that schools should concentrate on what high-quality, well-trained teachers can achieve in classrooms, rather than on the sociological challenges beyond their doors.
http://www.nytimes.com/2011/11/15/nyregion/calming-schools-through-a-sociological-approach-to-troubled-students.html?h
pw

One strategy in helping children to succeed is to recognize and treat depression.

Catherine de Lange reported in the New Scientist Health article, Spit test could allow depression screening at school:

A few globs of spit and a questionnaire could be all that’s needed to identify some teenagers who have a high risk of developing depression. That is the upshot of a study finding that teenage boys with elevated levels of the stress hormone cortisol, as well as depressive symptoms, can be 14 times more likely to become depressed later on.
It’s the first biological flag to accurately predict the risk of an individual going on to develop depression, says Barbara Sahakian at the University of Cambridge, one of the study’s authors.
The finding could lead to new pharmacological treatments for depression and could change the way schools deal with the condition. Teenagers could be screened for the biomarker and those at risk provided with targeted treatments.
Early predictor
Around the world, depression is one of the leading causes of disability. It takes hold early in life: half of all cases begin by age 14, three-quarters by 24.
“Given that we know more teenagers are getting depressed, we should be looking actively for people who are developing problems and treating them early and effectively,” Sahakian says.
Her team measured morning levels of cortisol over three days in 660 teenagers aged between 13 and 18. Elevated levels of this hormone have previously been implicated in depression. The team also recorded any pre-clinical depressive symptoms the teens reported over a year, such as tearfulness or lack of motivation. The study was later repeated in a group of about 1200 teens.
Teenage boys who reported high levels of depressive symptoms, and had high levels of cortisol, were more likely to have become clinically depressed over the next three years than any other combination. Those in this high risk group were 14 times more likely to go on to develop depression than the lowest-risk group, those who had neither high levels of cortisol nor depressive symptoms. Seventeen per cent of teens fell into this group but cortisol levels were not more useful than depression symptoms alone in pinpointing at-risk girls.
School intervention
Sahakian says screening pupils would be easy to do and beneficial, even if there were social stigma associated with identifying people who had a high risk of developing depression. “It’s better than leaving them alone in their bedrooms to get worse and worse,” she says. Screening could be carried out using saliva samples collected over a few days and students could fill out the questionnaire by themselves.
A study in the BMJ in 2012 found that having a professional therapist teach cognitive behavioural therapy (CBT) techniques to an entire class was no more effective than having the teacher give their usual personal social and health education classes, in terms of the effect on pupils’ well-being. But the hope is that screening would allow for targeted treatment.
Talking therapies such as CBT may also not be the best thing for boys, says Sahakian, because boys tend to respond better to visual techniques.
Screening could be a better way to allocate limited resources, says Carmine Pariante of the Institute of Psychiatry at King’s College London. Teenage years are a time of emotional turmoil, when pre-clinical symptoms of depression are likely to be common. “If you help all of the [people you see like this] you end up giving treatment and emotional support to those who might be alright,” he says. http://www.newscientist.com/article/dn25071-spit-test-could-allow-depression-screening-at-school.html#.UwcEwRzvqgk.email

Citation:

Elevated morning cortisol is a stratified population-level biomarker for major depression in boys only with high depressive symptoms
1. Matthew Owensa,b,
2. Joe Herbertc,
3. Peter B. Jonesa,b,
4. Barbara J. Sahakiand,
5. Paul O. Wilkinsona,
6. Valerie J. Dunna,b,
7. Timothy J. Croudacee, and
8. Ian M. Goodyera,b,1
Author Affiliations
1. Edited by Bruce S. McEwen, The Rockefeller University, New York, NY, and approved January 10, 2014 (received for review October 4, 2013)
1. Abstract
2. Authors & Info
3. SI
4. Metrics
5. PDF
6. PDF + SI
Significance
Clinical depression is a severe and common illness, characterized primarily by persistent low mood and lack of pleasure in usually enjoyable activities, that results in significant impairment in everyday living. It also involves alterations in cognitive and hormonal functions. There is substantial variation between depressed individuals in terms of the causes and therapeutic response, making it difficult to identify those most likely to benefit from intervention and treatment. We derived subtypes of adolescents in the population based on different levels of the hormone cortisol and subclinical depressive symptoms. A group (17%) with both high levels of cortisol and depressive symptoms of both sexes had more depressed thinking. Boys in this group were at high risk for clinical depression.
Abstract
Major depressive disorder (MD) is a debilitating public mental health problem with severe societal and personal costs attached. Around one in six people will suffer from this complex disorder at some point in their lives, which has shown considerable etiological and clinical heterogeneity. Overall there remain no validated biomarkers in the youth population at large that can aid the detection of at-risk groups for depression in general and for boys and young men in particular. Using repeated measurements of two well-known correlates of MD (self-reported current depressive symptoms and early-morning cortisol), we undertook a population-based investigation to ascertain subtypes of adolescents that represent separate longitudinal phenotypes. Subsequently, we tested for differential risks for MD and other mental illnesses and cognitive differences between subtypes. Through the use of latent class analysis, we revealed a high-risk subtype (17% of the sample) demarcated by both high depressive symptoms and elevated cortisol levels. Membership of this class of individuals was associated with increased levels of impaired autobiographical memory recall in both sexes and the greatest likelihood of experiencing MD in boys only. These previously unidentified findings demonstrate at the population level a class of adolescents with a common physiological biomarker specifically for MD in boys and for a mnemonic vulnerability in both sexes. We suggest that the biobehavioral combination of high depressive symptoms and elevated morning cortisol is particularly hazardous for adolescent boys.
• adolescence
gender differences
Footnotes
• 1To whom correspondence should be addressed. E-mail: ig104@cam.ac.uk.
• Author contributions: J.H., P.B.J., B.J.S., V.J.D., T.J.C., and I.M.G. designed research; V.J.D., J.H., P.B.J., T.J.C., M.O., and I.M.G. performed research; M.O., T.J.C., and I.M.G. analyzed data; and M.O., J.H., P.B.J., B.J.S., P.O.W., V.J.D., T.J.C., and I.M.G. wrote the paper.
• Conflict of interest statement: B.J.S. consults for Cambridge Cognition Ltd.
• This article is a PNAS Direct Submission.
• This article contains supporting information online at http://www.pnas.org/lookup/suppl/doi:10.1073/pnas.1318786111/-/DCSupplemental.

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Related:

Schools have to deal with depressed and troubled children https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’ https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:

1. About.Com’s Depression In Young Children
http://depression.about.com/od/child/Young_Children.htm

2. Psych Central’s Depression In Young Children
http://depression.about.com/od/child/Young_Children.htm

3. Psychiatric News’ Study Helps Pinpoint Children With Depression
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

4. Family Doctor’s What Is Depression?
http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

5. WebMD’s Depression In Children
http://www.webmd.com/depression/guide/depression-children

6. Healthline’s Is Your Child Depressed?
http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

7. Medicine.Net’s Depression In Children
http://www.onhealth.com/depression_in_children/article.htm

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

American Psychological Association: Kids too stressed out to be healthy

12 Feb

Moi said in Schools have to deal with depressed and troubled children:
Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.
As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Schools are developing strategies to deal with troubled kids.

Anna M. Phillips wrote the New York Times article, Calming Schools by Focusing on Well-Being of Troubled Students which describes how one New York school is dealing with its troubled children.

Mark Ossenheimer, principal of the Urban Assembly School for Wildlife Conservation in the Bronx, threw out a name to add to the list of teenagers in trouble.
Several teachers and a social worker seated around a table in the school’s cramped administrative offices nodded in agreement. They had watched the student, who had a housebound parent who was seriously ill, sink into heavy depression. Another child seemed to be moving from apartment to apartment, showing up at school only sporadically. And then there was the one grappling with gender-identity issues. Soon the list had a dozen names of students who could shatter a classroom’s composure or a school windowpane in a second.
Convening the meeting was Turnaround for Children, a nonprofit organization that the young-but-faltering school in an impoverished neighborhood near the Bronx Zoo had brought in this year to try to change things.
“This is the condition our organization was created to solve,” said Dr. Pamela Cantor, Turnaround’s founder and president. “A teacher who works in a community like this and thinks that these children can leave their issues at the door and come in and perform is dreaming.”
In focusing on students’ psychological and emotional well-being, in addition to academics, Turnaround occupies a middle ground between the educators and politicians who believe schools should be more like community centers, and the education-reform movement, with its no-excuses mantra. Over the past decade, the movement has argued that schools should concentrate on what high-quality, well-trained teachers can achieve in classrooms, rather than on the sociological challenges beyond their doors. http://www.nytimes.com/2011/11/15/nyregion/calming-schools-through-a-sociological-approach-to-troubled-students.html?hpw

One strategy in helping children to succeed is to recognize and treat depression. https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Carolyne Gregoire reported in the Huffington Post article, American Teens Are Even More Stressed Than Adults:

Last year, the American Psychological Association’s Stress in America survey found that Millennials, aged 18-33, were the country’s most-stressed generation. Now, the title belongs to an even younger demographic: American teenagers.
Even before the pressures of work and adulthood set in, for most young Americans, stress has already become a fact of daily life. And this sets the stage early for unhealthy behaviors and lifestyle choices that may increase the risk of developing stress-related health problems down the road.
American teenagers are now the most stressed-out age group in the U.S., according to APA’s 2013 Stress In America survey. While adults rate their stress at a 5.1 on a 10-point scale, teens rate their stress levels at 5.8.
This year’s report, conducted online by Harris Interactive on behalf of APA, consisted of 1,950 adults and 1,018 teens in the U.S. in August 2013. Here are some of the survey’s biggest findings about teens and stress:
• Teens report that their stress level during the school year (5.8/10) far exceeds what they believe to be a healthy level of stress (3.9/10).
• 31 percent of teens report feeling overwhelmed as a result of stress, 30 percent say that they feel sad or depressed as a result of stress, and 36 percent report feeling tired or fatigued because of stress.
• Only 16 percent of teens say their stress levels have declined in the past year, while 31 percent say their stress has increased in the past year.
• Yet teens are more likely than adults to report that stress has no effect on their physical health (54 percent) or their mental health (52 percent).
• 42 percent of teens say that they’re either not doing enough to manage their stress or they’re not sure if they’re doing enough.
“It is alarming that the teen stress experience is so similar to that of adults. It is even more concerning that they seem to underestimate the potential impact that stress has on their physical and mental health,” APA CEO and Executive Vice President Norman B. Anderson, PhD, said in a statement. “In order to break this cycle of stress and unhealthy behaviors as a nation, we need to provide teens with better support and health education at school and home, at the community level and in their interactions with health care professionals.”
Teens’ habits around sleep, exercise and technology (the average teen consumes an average of 7.5 hours of media per day) may play a role in contributing to higher stress levels. More than one in three teens says that stress has kept him up at night in the past month. But most teens aren’t sleeping enough to begin with: The average teen sleeps 7.4 hours on a school night (far less than the 9-10 hours recommended by the CDC), the APA survey found. The survey also found that one in five teens reports exercising less than once a week or not at all, despite the proven stress-relieving benefits of physical activity.
The negative health effects of lack of sleep and too much screen time for teens could be significant. Teens who don’t get enough sleep are four times as likely as well-rested teens to develop major depressive disorder, according to a recent University of Texas study, while teens who are already depressed are more likely to lose sleep. Teens who spend a lot of time on the Internet are also as likely to exhibit depressive symptoms and suicidal thoughts as teens who misuse drugs and skip school, according to a recent Swedish study…… http://www.huffingtonpost.com/2014/02/11/american-teens-are-even-m_n_4768204.html?utm_hp_ref=email_share

Here is the press release from the American Psychological Association:

Stress in America™ 2013 Highlights: Are Teens Adopting Adults’ Stress Habits?
While no one can avoid all stressful situations, this year’s Stress in America™ survey portrays a picture of high stress and ineffective coping mechanisms that appear to be ingrained in our culture, perpetuating unhealthy lifestyles and behaviors for future generations. While the news about American stress levels is not new, what’s troubling is the stress outlook for teens in the United States. In many cases, American teens report experiences with stress that follow a similar pattern to those of adults.
Teens and Stress
They report stress at levels far higher than what they believe is healthy and their average reported stress level is higher during the school year. Meanwhile, teens report that stress is having an impact on their life.
• Teens report that their stress level during the school year far exceeds what they believe to be healthy (5.8 vs. 3.9 on a 10-point scale) and tops adults’ average reported stress level in the past month (5.8 for teens vs. 5.1 for adults).
• Thirty-one percent of teens say that their stress level has increased in the past year and 34 percent believe their stress levels will increase in the coming year.
• Eighty-three percent report that school is a somewhat or significant source of stress, and 10 percent of teens report receiving lowers grades than they are capable of because of stress.
• Teens are more likely than adults to report that their stress level has a slight or no impact on their body or physical health (54 percent of teens vs. 39 percent of adults) or their mental health (52 percent of teens vs. 43 percent of adults). Yet teens report experiencing both emotional and physical symptoms of stress in similar proportions to adults, including feeling irritable or angry, nervous, anxious or and tired.
• Forty-two percent of teens say they either are not doing enough to manage their stress or they are not sure if they are doing enough to manage it.
• Thirty-seven percent of teen girls report feeling depressed or sad in the past month due to stress compared to 23 percent of teen boys.
• Although teens do not appear to recognize the potential impact of stress on their physical and mental health, they often struggle to cope. Only 50 percent report feeling confident about their ability to handle their personal problems, and 46 percent say they feel that they are on top of things fairly or very often.
More on teens and stress
Stress and Sleep
This year’s Stress in America survey shows that stress may be interfering with Americans’ sleep, keeping many adults and teens from getting the sleep they need to be healthy.
• Forty-three percent of American adults report that stress has caused them to lie awake at night in the past month.
• Forty-five percent of adults with higher reported stress levels (eight, nine or 10 on a 10-point scale) feel even more stressed if they do not get enough sleep.
• Thirty-five percent of teens report that stress caused them to lie awake at night in the past month. And for teens who sleep fewer than eight hours per school night, 42 percent say their stress level has increased over the past year.
More on stress and sleep
Stress and Exercise
Although many respondents to the Stress in America survey report that they experience positive benefits from exercise, few say they make the time to exercise every day. In fact, the survey found that 37 percent of adults report exercising less than once a week or not at all.
• Forty-three percent of adults say they exercise to manage stress, and 39 percent say they have skipped exercise or physical activity in the past month when they were feeling stressed.
• Fifty percent say that being physically active or fit is extremely or very important to them, yet only 27 percent report doing an excellent or very good job of achieving this.
• Fifty-three percent of teens say they feel good about themselves after exercising, 40 percent say it puts them in a good mood and 32 percent say they feel less stressed after exercising. Regardless, 20 percent of teens report exercising less than once a week or not at all.
More on stress and exercise
Stress and Eating
While many factors contribute to the nation’s weight challenges, the Stress in America survey suggests that stress influences our eating habits. Many adults report engaging in unhealthy eating behaviors as a result of stress.
• Thirty-eight percent of adults say they have overeaten or eaten unhealthy foods in the past month because of stress. Half of these adults (49 percent) report engaging in these behaviors weekly or more.
• Twenty-seven percent of adults say they eat to manage stress, and 34 percent of those who report overeating or eating unhealthy foods because of stress say this behavior is a habit.
• Among teens who report overeating or eating unhealthy foods because of stress (26 percent), 33 percent say they did so because it helps distract them from what was causing them stress.
• Sixty-seven percent of teens who report skipping meals due to stress say it was because of a lack of appetite, and 25 percent say it was because they did not have time to eat.
More on stress and eating
A Stress Snapshot
Survey results show that adults are living with stress that is higher than what they believe to be healthy and that they are not having much success at managing or reducing their stress.
• Forty-two percent of adults report that their stress level has increased, and 36 percent say their stress level has stayed the same over the past five years.
• Sixty-one percent of adults say that managing stress is extremely or very important, but only 35 percent say they are doing an excellent or very good job at it.
• Forty-four percent of adults say they are not doing enough or are not sure whether they are doing enough to manage their stress, but 19 percent say they never engage in stress management activities.
• Money (71 percent), work (69 percent) and the economy (59 percent) continue to be the most commonly reported sources of stress.
More on stress survey highlights
http://www.apa.org/news/press/releases/stress/2013/snapshot.aspx

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Related:

Schools have to deal with depressed and troubled children
https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children
https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’
https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:
1. About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

2. Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

3. Psychiatric News’ Study Helps Pinpoint Children With Depression http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

4. Family Doctor’s What Is Depression? http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

5. WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children

6. Healthline’s Is Your Child Depressed? http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

7. Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/