But a first-of-a-kind study conducted by researchers at the Kaiser Permanente Center for Health Research, Wesleyan University and Rutgers University found that more than 63 percent of participants had stopped binging at the end of the program – compared to just over 28 percent of those who did not participate. The program lasted only 12 weeks, but most of the participants were still binge free a year later. A second study, also published in the April issue of the Journal of Consulting and Clinical Psychology, found that program participants saved money because they spent less on things like dietary supplements and weight loss programs.

“It is unusual to find a program like this that works well, and also saves the patient money. It’s a win-win for everyone,” said study author Frances Lynch, PhD, MSPH, a health economist at the Kaiser Permanente Center for Health Research. “This type of program is something that all health care systems should consider implementing.”

“People who binge eat more than other people do during a short period of time and they lose control of their eating during these episodes. Binge eating is often accompanied by depression, shame, weight gain, loss of self-esteem and it costs the healthcare system millions of extra dollars,” said the study’s principal investigator Ruth H. Striegel-Moore, PhD, a professor of psychology at Wesleyan University. “Our studies show that recurrent binge eating can be successfully treated with a brief, easily administered program, and that’s great news for patients and their providers.”

Binge eating has received a lot of media attention recently because the American Psychiatric Association is recommending that it be considered a separate, distinct eating disorder like bulimia and anorexia. This new diagnosis can be expected to focus more attention on binge eating and how best to treat it, according to the researchers. It also could influence the number of people diagnosed and how insurers will cover treatment.

This randomized controlled trial, conducted in 2004-2005, involved 123 members of the Kaiser Permanente health plan in Oregon and southwest Washington. More than 90 percent of them were women, and the average age was 37. To be included in the study, participants had to have at least one binge eating episode a week during the previous three months with no gaps of two or more weeks between episodes.

Half of the participants were enrolled in the intervention and asked to read the book “Overcoming Binge Eating” by Dr. Christopher Fairburn, a professor of psychiatry and expert on eating disorders. The book details scientific information about binge eating and then outlines a six-step self-help program using self-monitoring, self-control and problem-solving strategies. Participants in the study attended eight therapy sessions over the course of12 weeks in which counselors explained the rationale for cognitive behavioral therapy and helped participants apply the strategies in the book. The first session lasted one hour, and subsequent sessions were 20-25 minutes. The average cost of the intervention was $167 per patient.

All participants were mailed fliers detailing the health plan’s offerings for healthy living and eating and encouraged to contact their primary care physician to learn about more services.

By the end of the 12-week program 63.5 percent of participants had stopped binging, compared to 28.3 percent of those who did not participate. Six months later, 74.5 percent of program participants abstained from binging, compared to 44.1 percent in usual care. At one year, 64.2 percent of participants were binge free, compared to 44.6 percent of those in usual care.

Everyone in the trial was asked to provide extensive information about their binge eating episodes, how often they missed work or were less productive at work, and the amount they spent on health care, weight-loss programs and weight loss supplements. Researchers also examined expenditures on medications, doctor visits, and other health-related services.

The researchers then compared these costs between the two groups and found that average total costs were $447 less in the intervention group. This included an average savings of $149 for the participants, who spent less on weight loss programs, over-the-counter medications and supplements. Total costs for the intervention group were $3,670 per person per year, and costs for the control group were $4,098.

As expected, participants in the intervention group spent less on weight loss programs and over-the-counter medications and supplements.

“While program results are promising, we highly encourage anyone who has problems with binge eating to consult with their doctors to make sure this program is right for them,” said study co-author Lynn DeBar, PhD, clinical psychologist at the Kaiser Permanente Center for Health Research.

Study authors include: Lynn DeBar, John F. Dickerson, Frances Lynch and Nancy Perrin from the Kaiser Permanente Center for Health Research in Portland, Oregon; Ruth H. Striegel-Moore and Francine Rosselli from Wesleyan University; G. Terence Wilson from Rutgers, The State University of New Jersey; and Helena C. Kraemer from the Stanford University School of Medicine.

Source:
Emily Schwartz
GolinHarris International

“Many fathers of sexually abused children want revenge and express the desire to torture their child’s aggressor,” says Allard, a PhD student at the Université de Montréal Department of Psychology. “Supporting the mother is essential to the recovery of the child. And the focus is often put on the mother because the father is the aggressor. But what happens in cases where the father is not the aggressor?”

Preliminary data provides some insight on the extent of the trauma experienced by fathers. “Their situation is particularly difficult,” says Allard. “The most violent reactions arise when the aggressor is the stepfather of the child, the mother’s new boyfriend or her new husband.”

Cases in which vengeance is not the dominant emotion are ones where the aggressor is a family member with whom the father has an emotional bond. This was the situation in more than 50 percent of cases.

For many fathers, the dominant emotion is grief. “Some fathers draw comparisons with the death of a loved one, as many grieve the death of their child’s innocence,” says Allard. “Fathers told us they became reluctant to tickle their child or give them a bath fearing that physical contact would remind the child of the aggression.”

In some cases, a child can reject their father because their aggressor was a man, too. These fathers struggle with deep feelings of helplessness and dismissal. On the other hand, an aggression can become an opportunity for advancing a father-child relationship, especially when the father realizes how sustaining such a relationship is in the best interest of their child.

Allard’s study is currently underway and supervised by Mireille Cyr, a professor at the Université de Montréal Department of Psychology as well as Milène Fernet of the Université du Québec à Montréal. Her research requires the continued contribution of fathers whose child has experienced sexual abuse.

Source:
Sylvain-Jacques Desjardins
University of Montreal

“I was surprised by the findings because the widely held assumption is that people are using their profiles to promote an enhanced impression of themselves,” says Gosling of the more than 700 million people worldwide who have online profiles. “In fact, our findings suggest that online social networking profiles convey rather accurate images of the profile owners, either because people aren’t trying to look good or because they are trying and failing to pull it off.

“These findings suggest that online social networks are not so much about providing positive spin for the profile owners,” he adds, “but are instead just another medium for engaging in genuine social interactions, much like the telephone.”

Gosling and a team of researchers collected 236 profiles of college-aged people from the United States (Facebook) and Germany (StudiVZ, SchuelerVZ). The researchers used questionnaires to assess the profile owners’ actual personality characteristics as well as their ideal-personality traits (how they wished to be). The personality traits included: extraversion, agreeableness, conscientiousness, neuroticism and openness.

In the study, observers rated the profiles of people they did not know. These ratings were then compared to the profile owners’ actual personality and their ideal-personality. Personality impressions based on online social network profiles were accurate and were not affected by profile owners’ self-idealization.

Accuracy was strongest for extraversion – paralleling results of face-to-face encounters – and lowest for neuroticism. Those findings were consistent with previous research showing that neuroticism is difficult to detect without being in person.

“I think that being able to express personality accurately contributes to the popularity of online social networks in two ways,” says Gosling. “First, it allows profile owners to let others know who they are and, in doing so, satisfies a basic need to be known by others. Second, it means that profile viewers feel they can trust the information they glean from online social network profiles, building their confidence in the system as a whole.”

Gosling recently co-authored a study on how first impressions do matter when it comes to communicating personality through appearance. For his latest personality research, he focuses his attention to personality in relation to online social networks.

Findings will be published in an upcoming issue of Psychological Science, a journal of the Association for Psychological Science. Researchers include: Gosling and Sam Gaddis (The University of Texas at Austin), Mitja Back, Juliane Stopfer and Boris Egloff (Johannes Gutenberg-University Mainz, Germany), Simine Vazire (Washington University in St. Louis), and Stefan Schmukle (Westfälische Wilhelms-University Münster, Germany).

Source:
Michelle Bryant
University of Texas at Austin

In addition to the insight into the normal fear response, the discovery may help to explain and perhaps even correct what goes wrong in those who suffer from panic attacks, the researchers say. (It’s been known for almost a century that carbon dioxide inhalation can trigger panic attacks, and that patients with panic disorder are particularly susceptible.)

“The amygdala has been thought of as part of the fear circuitry of the brain,” said John Wemmie of the University of Iowa, Iowa City. “Now we see it isn’t just part of a circuit, it is also a sensor.”

“It’s interesting that evolution positioned an acid sensor right in this central circuit,” added Michael Welsh, also of the University of Iowa. “Detecting an elevated carbon dioxide is critical for survival. When you are suffocating, this circuit triggers mechanisms for escape or relief of the problem.”

The circuit in question resides in the amygdala, a structure that stimulates the sympathetic nervous system for fight-or-flight and links to other brain regions involved in the response to threat. The amygdala is known from earlier studies to play a role in both innate and learned fears.

In previous studies, Wemmie’s and Welsh’s team discovered that the acid-sensing ion channel-1a (ASIC1a) is particularly abundant in the amygdala and other fear circuit structures, where it is required for normal responses in tests of fear behavior. As the name suggests, ASICs are sensitive to pH and become activated when pH levels fall.

The contribution of both the amygdala and ASIC1a to fear behavior led them to suspect that a reduced pH might induce fear behavior by activating the channels, thereby allowing the amygdala to function as a chemosensor deep within the fear circuit. And that’s exactly what they’ve now been able to show.

They found that inhaled carbon dioxide reduced brain pH and evoked fear behavior in mice. Mice breathing 5% carbon dioxide tended to avoid open spaces more than usual and, in standard tests of fear learning conducted in the presence of 10% carbon dioxide, the mice displayed exaggerated freezing behaviors.

Animals lacking those acid-sensing ion channels showed less fear, a condition that was reversed when the channels were reinstated specifically in their amygdala. Treatments that prevented the pH change reduced fear behavior, while acidic microinjections into the amygdala did just the opposite.

The new findings show that the amygdala not only senses the threat posed by carbon dioxide, but it also initiates a response. There is surely good reason for such an integrated alarm system.

“Because oxygen-breathing organisms are under a constant threat of asphyxiation, it could be argued that the threat of suffocation has had a primary influence on shaping the brain’s defensive systems,” wrote Stephen Marin of the University of Michigan, Ann Arbor in an accompanying commentary. “The present discovery that chemosensors in the amygdala are involved in generating fear responses to a variety of aversive stimuli suggests that a system that evolved to generate behavior to defend against suffocation was subsequently adapted to deal with both innate and learned threats in the external environment. In some regards, this is not surprising. In the grasp of a predator, suffocation is the ultimate fear – it signals imminent death.”

In addition to revealing the amygdala as an important chemosensor, the new results also give a molecular explanation for how rising carbon dioxide concentrations elicit intense fear and provide a foundation for dissecting the bases of anxiety and panic disorders, the researchers say. A single breath of carbon dioxide can trigger panic attacks in patients with panic disorder, they explained, and dysregulated brain pH has also been implicated in the condition. In addition, patients suffering from respiratory failure are also known to become extremely anxious.

“It has been proposed that panic and anxiety disorders involve a suffocation alarm gone haywire,” Welsh said. “Now, this work may shed some light on this well-known phenomenon and suggests strategies for further exploration.”

The findings raise the possibility that some people may be more prone to anxiety disorders, including post-traumatic stress disorder, due to genetic variants they carry in components of this ASIC pathway. They also suggest that new therapeutic strategies for panic and anxiety might target changes in brain pH or the acid-sensing channels.

The researchers include Adam E. Ziemann, University of Iowa, Iowa City, Iowa; Jason E. Allen, University of Iowa, Iowa City, Iowa; Nader S. Dahdaleh, University of Iowa, Iowa City, Iowa; Iuliia I. Drebot, University of Iowa, Iowa City, Iowa; Matthew W. Coryell, University of Iowa, Iowa City, Iowa; Amanda M. Wunsch, University of Iowa, Iowa City, Iowa; Cynthia M. Lynch, University of Iowa, Iowa City, Iowa; Frank M. Faraci, University of Iowa, Iowa City, Iowa; Matthew A. Howard III, University of Iowa, Iowa City, Iowa; Michael J. Welsh, University of Iowa, Iowa City, Iowa, Howard Hughes Medical Institute, and John A. Wemmie, University of Iowa, Iowa City, Iowa; Department of Veterans Affairs Medical Center, Iowa City, IA.

Source: Cathleen Genova
Cell Press