Children develop PTSD when they ruminate over their trauma

March 26, 2019

Science Daily/University of East Anglia

A new study shows that children are more likely to suffer PTSD if they think their reaction to a traumatic event is not 'normal'. While most children recover well after a traumatic event, some go on to develop PTSD that may stay with them for months, years, or even into adulthood. The research reveals that children begin down this route when they have trouble processing their trauma and perceive their symptoms as a sign that something is seriously wrong.

While most children recover well after a traumatic event, some go on to develop PTSD that may stay with them for months, years, or even into adulthood.

A new study, published today, reveals that children begin down this route when they have trouble processing their trauma and perceive their symptoms as being a sign that something is seriously wrong.

Lead researcher Prof Richard Meiser-Stedman, from UEA's Norwich Medical School, said: "Symptoms of PTSD can be a common reaction to trauma in children and teenagers. These can include distressing symptoms like intrusive memories, nightmares and flashbacks. Health professionals steer away from diagnosing it in the first month after a trauma because, rather than being a disorder, it's a completely normal response.

"Many children who experience a severe traumatic stress response initially can go on to make a natural recovery without any professional support. But a minority go on to have persistent PTSD, which can carry on for much longer.

"We wanted to find out more about why some children have significant traumatic stress symptoms in the days and weeks after a trauma and while others do not, and importantly -- why some recover well without treatment, while others go on to experience more persistent problems."

The research team worked with over 200 children aged between eight and 17 whaumao had attended a hospital emergency department following a one-off traumatic incident. These included events such as car crashes, assaults, dog attacks and other medical emergencies.

These young people were interviewed and assessed for PTSD between two and four weeks following their trauma, and again after two months.

The research team split the children's reactions into three groups -- a 'resilient' group who did not develop clinically significant traumatic stress symptoms at either time point, a 'recovery' group who initially displayed symptoms but none at the two month follow up, and a 'persistent' group who had significant symptoms at both time points.

The team also examined whether social support and talking about the trauma with friends or family may be protective against persistent problems after two months. They also took into account factors including other life stressors and whether the child was experiencing on-going pain.

Dr Meiser-Stedman said: "We found that PTSD symptoms are fairly common early on -- for example between two and four weeks following a trauma. These initial reactions are driven by high levels of fear and confusion during the trauma.

"But the majority of children and young people recovered naturally without any intervention.

"Interestingly the severity of physical injuries did not predict PTSD, nor did other life stressors, the amount of social support they could rely on, or self-blame.

"The young people who didn't recover well, and who were heading down a chronic PTSD track two months after their trauma, were much more likely to be thinking negatively about their trauma and their reactions -- they were ruminating about what happened to them.

"They perceived their symptoms as being a sign that something was seriously and permanently wrong with them, they didn't trust other people as much, and they thought they couldn't cope.

"In many cases, more deliberate attempts to process the trauma -- for example, trying to think it through or talk it through with friends and family -- were actually associated with worse PTSD. The children who didn't recover well were those that reported spending a lot of time trying to make sense of their trauma. While some efforts to make sense of trauma might make sense, it seems that it is also possible for children to get 'stuck' and spend too long focusing on what happened and why.

"The young people who recovered well on the other hand seemed to be less bothered by their reactions, and paid them less attention."

https://www.sciencedaily.com/releases/2019/03/190326081345.htm

Integrating infant mental health into the neonatal intensive care unit

April 3, 2019

Science Daily/Children's Hospital Los Angeles

Psychotherapists attend to mental health needs of NICU families, specifically focusing on the developing relationship between babies and parents.

Bringing a baby into the world involves many firsts -- mothers and fathers are discovering their new roles, babies are learning what it means to live outside the womb, and the family is forging a relationship and bonding. What happens when this time of uncertainty is complicated by medical issues?

Many infants born premature or with other complications often forego their first weeks or months at home for a stay in the neonatal intensive care unit. The NICU is designed to deliver critical medical care to babies in need but can be traumatic for infants and their families, alike. In the Early Childhood Mental Health Program at Children's Hospital Los Angeles, clinical psychologists Marian Williams, PhD, Patricia Lakatos, PhD, and a team of infant-family mental health specialists work towards greater mental health awareness in the NICU.

Infants may not be the first age group called to mind in discussions of mental health. Yet, for babies in critical medical condition, Dr. Lakatos says an "infant mental health-informed perspective" could reduce stress and improve bonding with parents. This means not only focusing on the physical needs of the child but also the emotional and mental needs, not an easy task for newborn infants who cannot make their voices heard.

In an article published in Journal of Clinical Psychology in Medical Settings, Dr. Lakatos, Dr. Williams, and co-authors Tamara Matic, MD, and Melissa Carson, MD, advocate for a third component of the NICU family -- the relationship between baby and parents. "A lot of mental health work in NICUs currently focus on either the mental health of parents or on the baby's development," says Dr. Williams, who is also the Director of the Stein Tikun Olam Infant-Family Mental Health Initiative at CHLA. "We also want to focus on the relationship between babies and their parents."

Many parents of children in intensive care units experience symptoms of post-traumatic stress, which can threaten bonding with a newborn baby. In order to support the developing relationship between parents and their new baby, the CHLA infant mental health team turned to a model of intervention that has demonstrated success in families who have undergone trauma. Child-Parent Psychotherapy -- or CPP -- addresses the parent-child relationship directly, nurturing and advocating for it in its own right.

With funding from the Stein Tikun Olam Infant-Family Health Initiative, Drs. Williams and Lakatos, and the team were able to adapt CPP to the NICU setting at Children's Hospital Los Angeles. Their publication describes how the established, evidence-based CPP model can be used to nurture developing infant-parent relationships in the NICU. While it has been implemented in other settings, CPP is not commonly integrated into NICU patient care.

CPP is a flexible model that has multiple levels of intervention, depending upon individual family needs. Sessions with trained CPP providers can vary in number or duration, with the aim of restoring a developmental trajectory for parent and child. CPP providers advocate for mental health needs of parents and babies, working alongside their medical and social work colleagues. "When babies are in the hospital, we need to think about them, their parents, and their relationships," says Dr. Lakatos.

Appropriately, NICU medical staff focus on the acute physical needs of the child. Dr. Williams sees clinical psychologists in a necessary, complementary role. "These babies are eventually going home," she says. "They are missing out on their bonding time, but there is great potential for resilience. Being mindful of the stressors these families are facing helps them feel understood and can set them on a positive trajectory."

https://www.sciencedaily.com/releases/2019/04/190403135019.htm

REM sleep silences the siren of the brain

Restless REM sleep a risk for many mental disorders?

July 11, 2019

Science Daily/Netherlands Institute for Neuroscience - KNAW

Upset by something unpleasant? We have all been there. Fortunately, it also passes. A new day, a new beginning. At least: if you have restful REM sleep. Researchers at the Netherlands Institute for Neuroscience discovered why you will be better able to bear tomorrow what you are distressed about today. And why that can go wrong.

Siren of the brain

Something frightening or unpleasant does not go unnoticed. In our brain, the so-called limbic circuit of cells and connections immediately becomes active. First and foremost, such experiences activate the amygdala. This nucleus of brain cells located deep in the brain can be regarded as the siren of the brain: attention! In order for the brain to function properly, the siren must also be switched off again. For this, a restful REM sleep, the part of the sleep with the most vivid dreams, turns out to be essential.

Good sleepers

The researchers placed their participants in a MRI scanner in the evening and presented a specific odor while they made them feel upset. The brain scans showed how the amygdala became active. The participants then spent the night in the sleep lab, while the activity of their sleeping brain was measured with EEG, and the specific odor was presented again on occasion. The next morning, the researchers tried to upset their volunteers again, in exactly the same way as the night before. But now they did not succeed so well in doing this. Brain circuits had adapted overnight; the siren of the brain no longer went off. The amygdala responded much less, especially in those who had had a lot of restful REM sleep and where meanwhile exposed to the specific odor.

Restless sleepers

However, among the participants were also people with restless REM sleep. Things went surprisingly different for them. Brain circuits had not adapted well overnight: the siren of the brain continued to sound the next morning. And while the nocturnal exposure to the odor helped people with restful REM sleep adapt, the same exposure only made things worse for people with restless REM sleep.

Neuronal connections weaken and strengthen

During sleep, 'memory traces' of experiences from the past day are spontaneously played back, like a movie. Among all remnants of the day, a specific memory trace can be activated by presenting the same odor as the one that was present during the experience while awake. Meanwhile, memory traces are adjusted during sleep: some connections between brain cells are strengthened, others are weakened. Restless REM sleep disturbs these nocturnal adjustments, which are essential for recovery and adaptation to distress.

Transdiagnostic importance

The findings were published on 11 July in the leading journal Current Biology. The finding can be of great importance for about two-thirds of all people with a mental disorder, as both restless REM sleep and a hyperactive amygdala are the hallmarks of post-traumatic stress disorder (PTSD), anxiety disorders, depression and insomnia. People with PTSD carry their traumatic experience to the next day: people with an anxiety disorder take their greatest fear with them, people with depression their despair, and people with chronic insomnia their tension. Authors Rick Wassing, Frans Schalkwijk and Eus van Someren predict that treatment of restless REM sleep could transdiagnostically help to process emotional memories overnight and give them a better place in the brain.

https://www.sciencedaily.com/releases/2019/07/190711141258.htm

Health and Wellness in Addiction Recovery

Story contribution by Hailey Parks

Living a healthy lifestyle is something that can easily fall to the wayside in today’s fast-paced, technology-driven society. Health and wellness can easily become something that is taken for granted. For people in recovery from addiction or alcoholism, health and wellness can be a tool used to treat mental health and help maintain sobriety. 

Addiction and Malnutrition

Those who suffer from addiction are likely to be malnourished, lacking the essential vitamins and nutrients to fuel their bodies for various reasons. 

• Opiate withdrawal can cause diarrhea, nausea, and vomiting which can lead to a lack of nutrients and an electrolyte imbalance. However, eating balanced meals during detox, including foods high in fiber, whole grain carbohydrates, and lean protein, can actually help make the detox process go smoother. 

• Alcohol abuse is one of the top causes of nutrient deficiency in the U.S. as people who abuse alcohol tend to lack B vitamins. In addition, many people who abuse alcohol can cause damage to their liver and pancreas, leading to metabolism problems. 

• Stimulants typically reduce user’s appetites causing weight loss, poor nutrition, dehydration, and electrolyte imbalances. 

Although abusing drugs or alcohol can lead to nutrient deficiencies, eating a balanced diet and getting sober can help reverse many of these issues. 

Nutrition in Recovery 

Eating a nutritious diet in early recovery can benefit both physical and mental health. For those choosing to detox, a great way to jump-start the detox process is to eat raw foods like fruits, vegetables, and nuts. Another essential aspect of making the detox process more bearable is by staying properly hydrated. 

After detox is over, it is important to keep in mind that drug or alcohol abuse can take a toll on the heart, liver, and brain. To help keep these essential organs healthy, one should consume foods like:

• Leafy greens

• Berries

• Nuts

• Avocados

• Almonds

• Dark chocolate

• Edamame

• Whole grains

• Green tea

• Beans

• Broccoli

• Lean protein

Eating this type of diet in early recovery can be especially difficult because it is common for people in recovery to crave sugary foods. When drugs and alcohol are removed, levels of dopamine drop. Eating sugar, on the other hand, can cause a surge in dopamine levels similar to that of the effects of drugs and alcohol. However, sugar can become an addiction in itself and lead to weight gain. In addition, eating excess sugar can cause fluctuating blood sugar levels. When blood sugar fluctuates up and down, a person can become anxious or depressed, causing their mental health to become unstable. When it comes to sobriety, mental health is just as important as physical health.

Exercise for Mental Clarity

Along with nutrition, exercise can be beneficial in promoting mental health in sobriety. Exercise can help boost mental health in several ways. 

• As little as 1 hour of physical activity a week is related to less anxiety and fewer drug cravings.

• Those who make exercise a regular part of their routine are less likely to suffer from depression, panic disorders, and anxiety.

• Serotonin increases during exercise which helps regulate sleep, appetite, and mood. 

• GABA and Glutamate are responsible for processing emotions and thought patterns. These chemicals are released during exercise which can prevent depression, anxiety, PTSD, and other mood disorders. 

• Exercise lowers stress and is a great outlet for mitigating negative emotions.

Keeping one’s mental health as a top priority during sobriety can help prevent relapse. After all, those who suffer from co-occurring mental illness and addiction typically have a difficult time maintaining sobriety due to the unique obstacles they face. By enjoying an active lifestyle, people in recovery can prevent their mental health symptoms from getting worse.

Mindfulness for Relaxation and Decision Making

It’s easy to let human instincts run the show when feeling anxious, but this can be a recipe for disaster in sobriety. Instead, it is important to learn how to relax in sobriety and to be mindful about making the right decisions. Mindfulness is a useful technique for relaxation and decision making that can be easily incorporated into daily routines 

Mindfulness has been proven to help alleviate stress by improving emotion regulation. When individuals have an appropriate way of regulating and processing emotions, they will be able to think clearly about decisions that need to be made. Practicing mindfulness can be as easy as laying down in a comfortable position, closing the eyes, and focusing on breathing. Another way to practice mindfulness is through looking up free mindful meditation videos on the internet. This practice will raise a person’s awareness of their body, energy, feelings, and surroundings. 

Practicing mindfulness is also attributed to:

• Increased attention and focus

• Lowered anxiety

• Relaxation

• Higher brain function

• Decreased heart rate and blood pressure

• A shift in perception and mental clarity

Health & Wellness in Maintaining Long Term Sobriety

By eating a nutritious diet, getting adequate exercise, and participating in mindful relaxation exercises, individuals help keep their mind and body healthy in sobriety. After all, people don’t get sober to feel unhealthy and depressed - people get sober to change their lifestyles for the better. Taking care of mental and physical health is a key aspect of living healthy and maintaining long term sobriety 

Hailey is a recovering alcoholic and addict who enjoys writing about addiction. After years of neglecting her physical and mental health in sobriety, she began to make dramatic changes in her lifestyle to be happier and healthier. Her passions include helping others, taking hikes with her dog, and spending time by the beach. 

Hailey Parks hailey.parks01 @ g mail .com

Psychedelic drugs promote neural plasticity in rats and flies

June 12, 2018

Science Daily/Cell Press

Psychedelic drugs may have mind-altering powers in the physical sense, too. A new study, published June 12 in the journal Cell Reports, found psychedelics, specifically DOI, DMT, and LSD, can change brain cells in rats and flies, making neurons more likely to branch out and connect with one another. The work supports the theory that psychedelics could help to fight depression, anxiety, addiction, and post-traumatic stress disorder.

"These are some of the most powerful compounds known to affect brain function, it's very obvious to me that we should understand how they work," says senior author David E. Olson, assistant professor in the Department of Chemistry and the Department of Biochemistry & Molecular Medicine at the University of California, Davis.

The idea that depression stems from imbalanced brain chemistry remains popular, but recent studies have revealed evidence that depression manifests as structural changes in brain circuits or atrophy in parts of the brain. This doesn't mean neurons die off during depression, but that neurites retract. Neurites are the sections -- either axons or dendrites -- of a neuron that project out to bridge the gap between two neurons at the synapse to facilitate communication.

"One of the hallmarks of depression is that the neurites in the prefrontal cortex -- a key brain region that regulates emotion, mood, and anxiety -- those neurites tend to shrivel up," says Olson. These brain changes also appear in cases of anxiety, addiction, and post-traumatic stress disorder.

In their paper, Olson and colleagues tested psychedelics from the amphetamine, tryptamine, and ergoline drug classes. In both test tube and animal experiments, the psychedelics showed functional and structural changes like those promoted by ketamine in cortical neurons. Psychedelics increased both the density of dendritic spines and the density of synapses. Some psychedelics tested, including LSD, proved to be more potent and efficacious than ketamine in promoting neurite growth.

The researchers did not do any human experiments, but experiments in both vertebrates and invertebrates showed psychedelics produced similar effects across species. This indicates the biological mechanisms that respond to psychedelics have remained the same across eons of evolution and that psychedelics will likely have the same brain growth (neural plasticity) effects in humans.

Olson and colleagues also set out to test how these psychedelics promoted neural plasticity, meaning they explored which biological pathways psychedelics activate that lead to neural growth. Ketamine's neural plasticity effects were previously shown to be dependent on a protein called brain-derived neurotrophic factor (BDNF). When the researchers blocked BDNF signaling, psychedelics lost their ability to promote neurite growth. BDNF binds to a receptor, called TrkB, that is part of a signaling pathway that includes mTOR, which is known to play a key role in the production of proteins necessary for the formation of new synapses. When the researchers experimented by inhibiting mTOR, it also completely blocked the psychedelics' ability to promote neurite growth. Olson thinks identifying the signaling pathways at play in psychedelic-induced brain changes will help future research identify compounds that could be developed into depression treatments.

"If we fully understand the signaling pathways that lead to neural plasticity, we might be able to target critical nodes along those pathways with drugs that are safer than ketamine or psychedelics," says Olson.

Although most psychedelics aren't considered to be addictive in the same way that cocaine is, they do produce hallucinations. Olson doesn't expect psychedelics to become prescription drugs for depression. "But a compound inspired by psychedelics very well could," he says.

https://www.sciencedaily.com/releases/2018/06/180612185207.htm

PTSD and Addiction Among Veterans: Causes, Comorbidity, and Treatment

April 2, 2019
By: Cassidy Webb

While the United States is fighting a fatal drug epidemic that is at fault for the deaths of far too many young people, veteran substance abuse continues to pose a growing problem in the nation. As military personnel are returning home from deployment, they are suffering from a vast variety of mental and physical health problems as a result of their experiences. With the comorbidity of co-occurring mental illnesses, such as Post-traumatic Stress Disorder (PTSD), and substance abuse being so prevalent, many veterans are suffering in silence from the progressive, chronic disease of addiction.

PTSD and Veterans
Due to the nature of military service and combat, many veterans are frequently exposed to life-threatening events that can lead to the development of PTSD. When stress is brought on by a traumatic experience, the brain enters a fight or flight response causing the alteration of brain chemicals and heart rate. Adrenaline begins to flow and blood pressure rises. While this response is a natural way for people to protect themselves against harm, those who experience this stress persistently after the danger has passed may have PTSD.

Symptoms of PTSD can begin shortly after the traumatic event occurs and could last a lifetime without treatment. These symptoms can include:

• Recall of memories from the event or flashbacks

• Difficulty coping with and expressing emotions

• May avoid situations that remind them of the traumatic event

• Jittery composure or unprecedented anger

• Difficulty sleeping

• Feelings of hopelessness or despair

Although statistics vary depending on the length of time in the military and the severity of the trauma, there is substantial evidence that veterans suffer from high rates of PTSD. In a study on veterans from Iraq and Afghanistan, it suggests that 14% suffer from PTSD and 39% suffer from alcohol abuse. For Vietnam veterans, rates of PTSD have been found to be as high as 31%. Despite the high necessity for treatment, as many as 50% of veterans who have PTSD do not receive the treatment they need.

PTSD can be a terrifying disorder that is difficult to cope with. For this reason, many veterans turn to alcohol or drugs to cope with their emotions.

Co-Occurring Disorders

The symptoms of PTSD are severe and can cause a lot of emotional distress on those who suffer from it. Unfortunately, many find solace by turning to drugs or alcohol to suppress their emotions and manage their symptoms as drugs and alcohol can increase pleasure, decrease anxiety, and distract an individual from their emotions. The comorbidity of PTSD and drug abuse is so severe that studies have found that nearly 52% of men and 28% of women with PTSD also have a substance use disorder.

While drugs and alcohol may allow individuals with PTSD to cope with their emotions in the short term, this often turns into a pattern of abuse that can lead to an addiction. After a substance is abused over an extended period of time, it becomes harder for the brain to regulate healthy amounts of dopamine. When the substances are suddenly removed, a person may experience a shortage of dopamine resulting in withdrawal symptoms. In turn, using substances to cope with the symptoms of PTSD can actually worsen symptoms. An affected person may suffer from insomnia, impaired judgment, and may engage in risky behaviors such as impaired driving or other illegal, dangerous activities.

Dual-Diagnosis Treatment

The cycle of PTSD and drug abuse is a vicious one if left untreated. On the other hand, if a person seeks treatment but only one condition is treated, they are left highly susceptible to relapse. Fortunately, forms of integrated therapy like dual-diagnosis can help treat both mental illness and substance use disorders simultaneously.

In order to get away from the persistent fight or flight mode that is so common with a PTSD diagnosis, it is important that the individual learns to identify and cope with their PTSD triggers by working closely with psychiatric and addiction specialists. Dual diagnosis therapy will generally consist of different treatment modalities, such as group therapy, individual therapy, cognitive behavioral therapy, and trauma-informed care. Individuals will be encouraged to look at their past and get to the root of their problems as well as learn of healthy coping techniques like deep breathing, meditation, and yoga.

Another benefit of dual diagnosis therapy is that clients will be able to get the right medications, like antidepressants and anti-anxiety drugs, to better treat their mental health. This combination of counseling, support, and medical treatment is typically used to help an individual with co-occurring PTSD and addiction reach a place where they are mentally and physically stable.

Treating addiction hand in hand with mental illness increases the likelihood of maintaining sobriety in the long term, and with the proper diagnosis and medications, symptoms of PTSD can be effectively managed.

Cassidy Webb is an avid writer from South Florida. She advocates spreading awareness on the disease of addiction. Her passion in life is to help others by sharing her experience, strength, and hope. cassidy@recoverylocal.org

Psychedelic therapy re-emerging for anxiety, PTSD and addiction

September 8, 2015

Science Daily/Canadian Medical Association Journal

Renewed medical interest in the use of psychedelic drugs for anxiety, posttraumatic stress disorder (PTSD) and addiction has resulted in small research studies that show some success with the controlled use of these drugs, according to an analysis published in CMAJ (Canadian Medical Association Journal).

Psychedelic drugs are substances that have a strong effect on one's "conscious experience," such as lysergic acid diethylamide (LSD), psilocybin, found in "magic mushrooms," dimethyltryptamine (DMT), mescaline and methylenedioxymethamphetamine (MDMA).

"The re-emerging paradigm of psychedelic medicine may open clinical doors and therapeutic doors long closed," writes Dr. Evan Wood, Professor of Medicine and Canada Research Chair, University of British Columbia, Vancouver, BC, and coauthors.

One small randomized controlled trial indicates that LSD-assisted psychotherapy might help reduce anxiety from terminal illness. Another small study, in which the active molecule in "magic mushrooms" was used as part of therapy for alcohol addiction, shows a significant reduction in the number of days alcohol was used as well as in the amount. A small US study of the drug MDMA shows a reduction in PTSD symptoms in people with chronic, treatment-resistant PTSD.

"Continued medical research and scientific inquiry into psychedelic drugs may offer new ways to treat mental illness and addiction in patients who do not benefit from currently available treatments," write the authors.

Learnings from research conducted in the 1950s and 1960s, in which there were challenges to conducting studies and ethical breaches, is helping inform current research in the field.

"Although methodological and political challenges remain to some degree, recent clinical studies have shown that studies on psychedelics as therapeutic agents can conform to the rigorous scientific, ethical and safety standards expected of contemporary medical research," the authors write.

Canadian researchers are leading studies that are looking at psychedelic drugs as treatment for addiction and PTSD.

The authors emphasize that the studies included in their analysis are small and the results preliminary; further research is needed to determine if there is widespread clinical application.

https://www.sciencedaily.com/releases/2015/09/150908131419.htm

Teens with a history of TBI are nearly 4 times more likely to have used crystal meth

November 26, 2014

Science Daily/St. Michael's Hospital

Ontario students between Grades 9 and 12 who said they had a traumatic brain injury in their lifetime, also reported drug use rates two to four times higher than peers with no history of TBI, according to research published today in The Journal of Head Trauma Rehabilitation.

"Overall, a teen with a history of TBI is at least twice as likely as a classmate who hasn't suffered a brain injury to drink alcohol, use cannabis or abuse other drugs," said Dr. Michael Cusimano, co-principal investigator of the study and a neurosurgeon at St. Michael's Hospital. "But when you look at specific drugs, those rates are often higher."

The research showed that, in the past 12 months, teens with a history of TBI said they were:

·     3.8 times more likely to have used crystal meth

·     3.8 times more likely to have used non-prescribed tranquilizers or sedatives

·     2.8 times more likely to have used Ecstasy

·     2.7 times more likely to have used non-prescribed opioid pain relievers

·     2.6 times more likely to have used hallucinogens

·     2.5 times more likely to have used cocaine

·     2.5 times more likely to have used LSD

·     2.1 times more likely to have used non-prescribed ADHD drugs

"On top of the other health consequences, substance abuse increases the odds of suffering an injury that could result in a TBI," said Dr. Cusimano, who is also a researcher with the Keenan Research Centre for Biomedical Science. "And using some of these substances may also impair recovery after injury."

Teens with a self-reported history of TBI also reported they were 2.5 times more likely to have smoked one or more cigarettes daily over the past 12 months and nearly twice as likely to have binge drank -- consuming five or more drinks in one sitting -- in the past four weeks.

Researchers defined TBI as any hit or blow to the head that resulted in the teenager being knocked out for at least five minutes or spending at least one night in hospital due to symptoms associated with the head injury. Some of these brain injuries could have been also called concussions, which are mild to moderate forms of TBI.

"Some people think of concussions as a less alarming injury than a mild TBI but this is wrong," said Dr. Cusimano. "Every concussion is a TBI. People should take every brain injury seriously because, as this research shows, the immediate and long-term effects can alter lives."

The data used in the study was from the 2011 Ontario Student Drug Use and Health Survey developed by the Centre for Addiction and Mental Health. The survey is one of the longest ongoing school surveys in the world. The OSDUHS began as a drug use survey, but is now a broader study of adolescent health and well-being. Questions about traumatic brain injury were added to the survey for the first time in 2011.

The study looked at reported substance use among 6,383 Ontario students in Grades 9 through12. Data allowed researchers to determine the substance use habits and history of TBIs among students but did not allow researchers to determine whether substance use or brain injury came first.

"These data show us that there are important links between adolescent TBI and substance use," said Dr. Robert Mann, co-principal investigator of the study, senior scientist at CAMH and director of the OSDUHS. "While we can't yet say which one causes the other, we know this combination of factors is something to watch because it can have a serious negative impact on young people as they develop."

Dr. Mann said the relationship between TBI and substance use is concerning and calls for greater focus on prevention. "In terms of our research, the next step is to get a better understanding of the direction of these behaviours and to hopefully pinpoint when and how this relationship starts."

https://www.sciencedaily.com/releases/2014/11/141126185146.htm

Study reveals how ecstasy acts on brain, hints at therapeutic uses

January 17, 2014

Science Daily/Imperial College London

Brain imaging experiments have revealed for the first time how ecstasy produces feelings of euphoria in users.

Results of the study at Imperial College London, parts of which were televised in Drugs Live on Channel 4 in 2012, have now been published in the journal Biological Psychiatry.

The findings hint at ways that ecstasy, or MDMA, might be useful in the treatment of anxiety and post-traumatic stress disorder (PTSD).

MDMA has been a popular recreational drug since the 1980s, but there has been little research on which areas of the brain it affects. The new study is the first to use functional magnetic resonance imaging (fMRI) on resting subjects under its influence.

Twenty-five volunteers underwent brain scans on two occasions, one after taking the drug and one after taking a placebo, without knowing which they had been given.

The results show that MDMA decreases activity in the limbic system -- a set of structures involved in emotional responses. These effects were stronger in subjects who reported stronger subjective experiences, suggesting that they are related.

Communication between the medial temporal lobe and medial prefrontal cortex, which is involved in emotional control, was reduced. This effect, and the drop in activity in the limbic system, are opposite to patterns seen in patients who suffer from anxiety.

MDMA also increased communication between the amygdala and the hippocampus. Studies on patients with PTSD have found a reduction in communication between these areas.

The project was led by David Nutt, the Edmond J. Safra Professor of Neuropsychopharmacology at Imperial College London, and Professor Val Curran at UCL.

Dr Robin Carhart-Harris from the Department of Medicine at Imperial, who performed the research, said: "We found that MDMA caused reduced blood flow in regions of the brain linked to emotion and memory. These effects may be related to the feelings of euphoria that people experience on the drug."

Professor Nutt added: "The findings suggest possible clinical uses of MDMA in treating anxiety and PTSD, but we need to be careful about drawing too many conclusions from a study in healthy volunteers. We would have to do studies in patients to see if we find the same effects."

MDMA has been investigated as an adjunct to psychotherapy in the treatment of PTSD, with a recent pilot study in the US reporting positive preliminary results.

As part of the Imperial study, the volunteers were asked to recall their favourite and worst memories while inside the scanner. They rated their favourite memories as more vivid, emotionally intense and positive after MDMA than placebo, and they rated their worst memories less negatively. This was reflected in the way that parts of the brain were activated more or less strongly under MDMA. These results were published in the International Journal of Neuropsychopharmacology.

Dr Carhart-Harris said: "In healthy volunteers, MDMA seems to lessen the impact of painful memories. This fits with the idea that it could help patients with PTSD revisit their traumatic experiences in psychotherapy without being overwhelmed by negative emotions, but we need to do studies in PTSD patients to see if the drug affects them in the same way."

https://www.sciencedaily.com/releases/2014/01/140117103941.htm

Neurofeedback gets you back in the zone

New study from biomedical engineers demonstrates that a brain-computer interface can improve your performance

March 12, 2019

Science Daily/Columbia University School of Engineering and Applied Science

Researchers have shown -- for the first time -- that they can use online neurofeedback to modify an individual's arousal state to improve performance in a demanding sensory motor task, such as flying a plane or driving in suboptimal conditions.

Our state of arousal -- being fearful, agitated, or calm -- can significantly affect our ability to make optimal decisions, judgments, and actions in real-world dynamic environments. Imagine, for instance, walking across a balance beam. Your performance -- speed across the beam and the odds of making it across without falling off -- are dramatically better if the beam sits a mere six inches off the ground and you are relaxed rather than terror-stricken on a beam 60 feet higher. To keep you in the zone of maximum performance, your arousal needs to be at moderate levels, not so high that it pushes you over the edge.

Biomedical engineers at Columbia Engineering have shown -- for the first time -- that they can use online neurofeedback to modify an individual's arousal state to improve performance in a demanding sensory motor task, such as flying a plane or driving in suboptimal conditions. The researchers used a brain computer interface (BCI) to monitor, through electroencephalography (EEG) in real time, the arousal states of the study participants when they were engaged in a virtual reality aerial navigation task. The system generated a neurofeedback signal that helped participants to decrease their arousal in particularly difficult flight situations, which in turn improved participants' performance. The study was published today by Proceedings of the National Academy of Sciences.

"The whole question of how you can get into the zone, whether you're a baseball hitter or a stock trader or a fighter pilot, has always been an intriguing one," says Paul Sajda, professor of biomedical engineering (BME), electrical engineering, and radiology, who led the study. "Our work shows that we can use feedback generated from our own brain activity to shift our arousal state in ways that significantly improve our performance in difficult tasks -- so we can hit that home run or land on a carrier deck without crashing."

The 20 subjects in the study were immersed in a virtual reality scenario in which they had to navigate a simulated airplane through rectangular boundaries. Known as a boundary avoidance task, this demanding sensory-motor task model created cognitive stresses, such as making the boxes narrower every 30 seconds, that escalated arousal and quickly resulted in task failure -- missing or crashing into the boundary. But when the researchers used neurofeedback, the subjects did better, were able to fly longer while performing the difficult tasks that required high levels of visual and motor coordination.

There were three feedback conditions (BCI, sham, and silence) randomly assigned for every new flight attempt. In the BCI condition, subjects heard the sound of a low-rate synthetic heartbeat that was continuously modulated in loudness as a function of the level of inferred task-dependent arousal, as decoded from the EEG. The higher that level of arousal, the louder the feedback and vice versa. Participants' task performance in the BCI condition, measured as time and distance over which the subject can navigate before failure, was increased by around 20 percent.

"Simultaneous measurements of pupil dilation and heart rate variability showed that the neurofeedback indeed reduced arousal, causing the subjects to remain calm and fly beyond the point at which they would normally fail," says Josef Faller, the study's lead author and a postdoctoral research scientist in BME. "Our work is the first demonstration of a BCI system that uses online neurofeedback to shift arousal state and improve task performance in accordance with the Yerkes-Dodson law."

The Yerkes-Dodson law is a well-established and intensively studied law in behavioral psychology about the relationship between arousal and performance. Developed in 1908, it posits an inverse-relationship between arousal and task performance, that there is a state of arousal that is optimal for behavioral performance in a given task. In this new study, the researchers showed that they could use neurofeedback in real time to move an individual's arousal from the right side of the Yerkes-Dodson curve to the left, toward a state of improved performance.

"What's exciting about our new approach is that it is applicable to different task domains," Sajda adds. "This includes clinical applications that use self-regulation as a targeted treatment, such as mental illness."

The researchers are now studying how neurofeedback can be used to regulate arousal and emotion for clinical conditions such as PTSD. They are also exploring how they might use online monitoring of arousal and cognitive control to inform human-agent teaming, when a robot and a human work together in a high-stress situation like a rescue. If the robot has information on the human's arousal state, it could choose its tasks in a way that reduces its teammate's arousal, pushing her/him into an ideal performance zone.

"Good human-agent teams, like the Navy SEALS, do this already, but that is because the human-agents can read facial expressions, voice patterns, etc., of their teammates to infer arousal and stress levels," Sajda says. "We envision our system being a better way to communicate not just this type of information, but much more to a robot-agent."

https://www.sciencedaily.com/releases/2019/03/190312143206.htm