New Tool for Depression – Focus on Positive Future Expectations

For years, I’ve been teaching clients simple frameworks to manage the emotional mind. These frameworks have to be accessible within 1/3rd of a second, before the emotional mind hijacks the rational mind.

A powerful example of this is the framework developed by Phillip Zimbardo at Stanford regarding time perspectives and valence, which is a fancy way of saying that our attention can take you certain places – internal (e.g., monitoring your heart rate, your thoughts) or external (e.g., the room you are in, the people you are with); past, present or future; and/or positive or negative emphasis.

From Ken Pope’s excellent newsletter…

*CNS Neuroscience & Therapeutics* has scheduled an article for publication in a future issue: “Treating Major Depression by Creating Positive Expectations for the Future: A Pilot Study for the Effectiveness of Future-Directed Therapy (FDT) on Symptom Severity and Quality of Life.”

The authors are Jennice S. Vilhauer, Sabrina Young, Chanel Kealoha, Josefine Borrmann, Waguih W. IsHak, Mark H. Rapaport, Narineh Hartoonian, & Jim Mirocha.

Here’s the abstract:

[begin excerpt]

Introduction: This nonrandomized pilot study assesses the efficacy of a new future-oriented form of therapy, known as future-directed therapy (FDT), as a treatment for patients with Major Depressive Disorder (MDD) in a naturalistic hospital-based outpatient psychiatry clinic. The study measured symptom severity of depression and anxiety, in addition to quality of life pre- and posttreatment.

Aims: The study examined a new manualized treatment designed to help people anticipate a more positive future. The intervention consists of twenty 90-min group sessions administered twice a week over 10 weeks. The intervention was compared to depressed patients in the same clinic who enrolled in traditional cognitive-based group psychotherapy. Sixteen patients with MDD completed the FDT intervention as part of their outpatient treatment for depression. Seventeen patients with MDD participated in treatment as usual (TAU) cognitive-based group therapy. The Quick Inventory of Depressive Symptoms, the Beck Anxiety Inventory, and the Quality-of-Life Enjoyment and Satisfaction Questionnaire short form, self-report instruments were administered prior to and immediately after the completion of therapy.

Results: Patients treated with FDT demonstrated significant improvements in depression (P= 0.001), anxiety (P= 0.021) and quality of life (P= 0.035), and also reported high satisfaction with the therapy. Compared to the TAU group, patients treated with FDT showed greater improvements in depressive symptoms (P= 0.049).

Conclusions: FDT may have the potential of becoming an additional treatment option for patients with MDD.

[end excerpt]

On the Cedars-Sinai (where the research was conducted) web site there was the following additional information:

[begin Cedars-Sinai info]

Patients with major depression do better by learning to create a more positive outlook about the future, rather than by focusing on negative thoughts about their past experiences, researchers at Cedars-Sinai say after developing a new treatment that helps patients do this.

While Major Depressive Disorder patients traditionally undergo cognitive-behavior therapy care that seeks to alter their irrational, negative thoughts about past experiences, patients who were treated with the newly-developed Future-Directed Therapy(TM) demonstrated significant improvement in depression and anxiety, as well as improvement in overall reported quality of life, the researchers found.

Results were published recently in the peer-reviewed journal CNS Neuroscience & Therapeutics.

“Recent imaging studies show that depressed patients have reduced functioning in the regions of the brain responsible for optimism,” said Jennice Vilhauer, PhD, study author and clinical director of Adult Outpatient Programs for the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences. “Also, people with depression tend to have fewer skills to help them develop a better future. They have less ability to set goals, problem solve or plan for future events.”

According to the U.S. Centers for Disease Control and Prevention, an estimated one in 10 American adults meet the diagnostic criteria for depression.

Anand Pandya, MD, interim chair of Cedars-Sinai’s Department of Psychiatry and Behavioral Neurosciences, said, “Future-Directed Therapy is designed to reduce depression by teaching people the skills they need to think more positively about the future and take the action required to create positive future experiences.  This is the first study that demonstrates this intervention intended to increase positive expectations about the future can reduce symptoms of Major Depressive Disorder.”

Depression in Men depressed guys

When people talk only about the negative aspects of their lives, it causes them to focus more attention on what makes them unhappy, Vilhauer said.

“Talking about what makes you unhappy in life doesn’t generate the necessary thinking patterns or action needed to promote a state of thriving and create a more positive future,” Vilhauer said.  “Future-Directed Therapy helps people shift their attention constructing visions of what they want more of in the future and it helps them develop the skills that they will need to eventually get there.”

In the study conducted at Cedars-Sinai, 16 adult patients diagnosed with Major Depressive Disorder attended future-directed group therapy sessions led by a licensed psychologist twice a week for 10 weeks.  Each week, patients read a chapter from a Future-Directed Therapy manual and completed worksheets aimed at improving certain skills, such as goal-setting.  Another group of 17 patients diagnosed with depression underwent standard cognitive group therapy. The study team measured the severity of depression and anxiety symptoms, and quality of life before and after treatment, using the Quick Inventory of Depressive Symptoms, the Beck Anxiety Inventory, and the Quality-of-Life Enjoyment and Satisfaction Questionnaire short form.

Results include:

Patients in the Future-Directed Therapy group experienced on average a 5.4 point reduction in their depressive symptoms on the Quick Inventory of Depressive Symptoms scale, compared to a two point reduction in the cognitive therapy group.

Patients in the Future-Directed Therapy group on average reported a 5.4 point reduction in anxiety symptoms on the Beck Anxiety Inventory, compared to a reduction of 1.7 points in the cognitive therapy group.

Patients in the Future-Directed Therapy group reported on average an 8.4 point improvement in their self-reported quality of life on the Quality of Life Enjoyment and Satisfaction scale, compared to a 1.2 point improvement in the cognitive therapy group.

[end Cedars-Sinai info]

The author note provides the following contact information: Jennice Vilhauer, Ph.D., Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, 8730 W. Alden Drive, Thalians W-101, Los Angeles, CA, USA. Tel.: +(310) 423-2620; Fax: +(310) 423-0114; E-mail:

<vilhauerj@cshs.org>.

Depressed Men Often Trade Places with Spouse Per New Study

From ScienceDaily.com…

Depressed Man Depression in Men

‘Trading Places’ Most Common Pattern for Couples Dealing With Male Depression

ScienceDaily (Oct. 21, 2011) — University of British Columbia researchers have identified three major patterns that emerge among couples dealing with male depression. These can be described as “trading places,” “business as usual” and “edgy tensions.”

Published in the Social Science & Medicine journal and led by UBC researcher John Oliffe, the paper details how heterosexual couples’ gender roles undergo radical shifts and strain when the male partner is depressed and the female partner seeks to help. Depression, a disorder often thought of as a women’s health issue, is underreported in men, and little is known about how heterosexual couples respond when the male partner is depressed.

“Overall, our study underscores how women play a key role in helping their male partners manage their depression,” says Oliffe, an associate professor in the School of Nursing whose work investigates masculinities and men’s health with a focus on men’s depression.

“Our findings suggest that gender relations are pivotal in how health decisions are made in families and for that reason, it’s important to understand couple dynamics if we want to have effective interventions.”

Oliffe and his UBC colleagues found that “trading places” is the most common pattern. In these relationships, the partners took on atypical masculine and feminine roles to cope with challenges caused by the men’s depression. For instance, men assumed the role of homemaker while the women became the family breadwinner.

Oliffe says, “Here, women partners also broke with feminine ideals in how they provided partner support by employing tough love strategies for self-protection and a means of prompting the men’s self-management of their depression.”

The second most common pattern is “business as usual,” when couples sought to downplay or mask any problems caused by the men’s depression. Holding firm to idealized heterosexual gender roles, the women continued to support and nurture their partners. Despite their ongoing struggles with depression, the men continued to work hard to maintain their careers in typically masculine arenas, which in the study included engineering, science, law enforcement, forestry and coaching.

The third pattern, “edgy tensions,” describes men and women caught in dysfunctional relationships. Each holding ideas of gender roles that differed from those of their partner, these couples grappled with resentment. The men resisted medical treatment. Instead, they used alcohol and illicit drugs, at least in part, to self-manage their depression. The women expressed ambivalence about conforming to the feminine ideal of being a “selfless nurturer,” especially for men who were volatile and unpredictable. The men in turn espoused a view of themselves as head of the household.

The study conducted qualitative analysis through in-depth interviews with 26 men, diagnosed or self identified as depressed, and their 26 partners, from Prince George, Kelowna and Vancouver. The study participants ranged in age from 20 to 53 years old. The duration of the couples’ relationships ranged from two months to 18 years; seven couples had children living at home.

The men self-identified as Anglo-Canadian, First Nations, European, Asian and Middle Eastern. Seven couples were in mixed ethnicity relationships. The men had varying levels of education ranging from some high school to graduate degrees; 14 of the 26 men were unemployed at the time of interview, and self-identified as being of low socio-economic status as a consequence.

This research received support through the Canadian Institutes of Health Research, Institute of Gender and Health.

Story Source:

The above story is reprinted from materials provided by University of British Columbia.

Journal Reference:

John L. Oliffe, Mary T. Kelly, Joan L. Bottorff, Joy L. Johnson, Sabrina T. Wong. “He’s more typically female because he’s not afraid to cry”: Connecting heterosexual gender relations and men’s depression. Social Science & Medicine, 2011; 73 (5): 775 DOI: 10.1016/j.socscimed.2011.06.034

Mental Illness Will Hit 1 Out of 2 Adults in U.S. – Anxiety Not Well Tracked

I have spent nearly a lifetime trying to understand, manage and fix the human mind. The mind fascinates, torments, inspires, belittles, loves, and elevates. So it was with great interest that I read that the CDC came out with a new report on mental illness, including anxiety and depression.

Mental illness, anxiety, depression affect 50% of US Adults

The Center for Disease Control just released their report, Mental Illness Surveillance Among Adults in the United States (September 2, 2011), outlining  the tremendous reach that mental illness has into my life, your life and every other life in the United States of America.

Some highlights from the report

In the United States, the economic impact of mental illness  is enormous, roughly $300 billion in 2002. No more recent numbers are available, but the cost is rising.

Approximately 25% of adults in the U.S. have a mental illness. That means one out of every four individuals are dealing with some form of mental illness (e.g., anxiety, depression, other mood disorders, psychosis, OCD, ADHD, personality disorders, etc.). The report defines mental illness as all diagnosable mental disorders. Effects of mental illness may involve chronic abnormal thoughts, moods, or behaviors associated with distress and impaired  functioning. The effects of mental illnesses include disruptions of daily function; incapacitating personal, social, and occupational impairment; and premature death. The most common ones are anxiety and mood disorders (e.g., depression and bipolar disorder).

Almost 50% of American adults will experience at least one mental illness in their lifetime.

Mental illness leads to more disability than any other group of illnesses. More than even heart disease and cancer!
Anxiety disorders anger management classes
The Mental Impacts the Physical and Vice-versa

Most mental illnesses are fundamentally intertwined with chronic medical disorders like heart disease, addiction and obesity. So the manner in which our mind works dramatically impacts how well your body works.

Mental illness is a massive public health problem. Check out these facts from the World Health Organization…

  • ‘mental illness is associated with increased occurrence of chronic diseases such as cardiovascular disease, diabetes, obesity, asthma, epilepsy, and cancer;
  • mental illness is associated with lower use of medical care, reduced adherence to treatment therapies for chronic diseases, and higher risks of poor health outcomes;
  • mental illness is associated with use of cigarettes, chewing tobacco and abuse of alcohol;
  • rates for both intentional (e.g., homicide, suicide) and unintentional (e.g., motor vehicle) injuries are 2 to 6 times higher among people with a mental illness than in the population overall;
  • many mental illnesses can be managed successfully, and increasing access to and use of mental health treatment services could substantially reduce the associated death rate and
  • many chronic illnesses are associated with mental illnesses, and it’s been shown that treatment of mental illnesses associated with chronic diseases can reduce the effects of both and support better outcomes.’

Interestingly, there are currently no efforts at the national or state level to track anxiety disorders. Yet, anxiety disorders occur just as frequently as depression.
What’s more, anxiety disorders are similar to depression in that they

  1. negatively impact daily functioning as much as depression,
  2. are closely tied to the stress response system in the body,
  3. have similar negative effects on physical health, and
  4. are frequently found to exist together with the same physical illnesses as those that exist in folks who suffer from depression.

In conclusion, it appears that we are lagging in monitoring the prevalence of anxiety and providing assistance for those who struggle with anxiety. Mental illness is just beginning to get adequate exposure so that we can continue to develop cutting-edge tools and technologies to help those who suffer from it. We can no longer afford to bury our heads in the sand and ignore the compounding costs of mental illness. It is time to bring mental illness into the light where it can be appropriately identified and treated without shame.

What are your thoughts on this CDC report?

How have you been affected by mental illness in your life?

Please leave a comment below to get the conversation started!

All the best,

John Schinnerer, Ph.D.

Founder, Guide to Self, Inc.

Award-winning author of Guide to Self: The Beginner’s Guide to Managing Emotion and Thought (for a free PDF version, visit http://www.GuidetoSelf.com and enter your name and email address)

Award-winning blogger on The Shrunken Mind – a top 3 blog on positive psychology

Free online anger management classes which incorporate humor and positive psychology at WebAngerManagement.com

 

Call of Duty & Mortal Kombat 9 Linked to Greater Aggression & Anger Management Problems

  

Mike’s fist explodes in the teenager’s face like a car bomb detonating in the middle of Times Square. He has heavy, brick hands that smack right through the skin and skull of his opponent. Hit after hit rain down – head, body, head, head. His opponent’s knees wobble from sledgehammer blows, the brain temporarily ceasing to defend the body. Sensing the opening, Mike grabs the shoulders of his adversary and yanks the boy’s head straight down onto his rapidly rising knee. The jolt snaps the boy’s head back as a thick spray of metallic-tasting, black blood spurts from his mouth and nose. Barely conscious, the boy’s head cracks against the pavement. Blood leaks onto the concrete. He is no longer a threat, yet Mike continues to kick his torso and stomp on his head. Mike picks up the limp, lifeless body and slams the other boy’s head against the hood of a 2008 Dodge Charger, leaving a dent in the hood and head. As he lifts his fist to continue the carnage, Mike’s friends grab his arm, saying “I think you’ve done enough. He’s finished.” Mike drops the boy on the ground, unconscious, bleeding, concussed and injured for life.

This fight and countless others occurred at Snake Park in Blackhawk, CA.  I see clients with anger management problems daily. My clients tell me all about the frequent fights that occur in the San Ramon Valley. My sense is that, over the past two decades, fighting among adolescent males has increased in aggression, violence and desensitization. Every adolescent male client that I see plays highly violent video games on a daily basis. Games such as Call of Duty (COD), KillZone, and Mortal Kombat 9. This is on top of playing realistic and painful war games with Air Soft guns.

And just to give you a little taste of what gamers are repeatedly seeing, here is a sample fatality from the latest Mortal Kombat…

So you can imagine my concern when the following study came out today…

Violent Video Games Reduce Brain Response to Violence and Increase Aggressive Behavior, Study Suggests

 

ScienceDaily (May 25, 2011) — Scientists have known for years that playing violent video games causes players to become more aggressive. The findings of a new University of Missouri (MU) study provide one explanation for why this occurs: the brains of violent video game players become less responsive to violence, and this diminished brain response predicts an increase in aggression.

 

“Many researchers have believed that becoming desensitized to violence leads to increased human aggression. Until our study, however, this causal association had never been demonstrated experimentally,” said Bruce Bartholow, associate professor of psychology in the MU College of Arts and Science.

 

During the study, 70 young adult participants were randomly assigned to play either a nonviolent or a violent video game for 25 minutes. Immediately afterwards, the researchers measured brain responses as participants viewed a series of neutral photos, such as a man on a bike, and violent photos, such as a man holding a gun in another man’s mouth. Finally, participants competed against an opponent in a task that allowed them to give their opponent a controllable blast of loud noise. The level of noise blast the participants set for their opponent was the measure of aggression.

 

The researchers found that participants who played one of several popular violent games, such as “Call of Duty,” “Hitman,” “Killzone” and “Grand Theft Auto,” set louder noise blasts for their opponents during the competitive task — that is, they were more aggressive — than participants who played a nonviolent game. In addition, for participants that had not played many violent video games before completing the study, playing a violent game in the lab caused a reduced brain response to the photos of violence — an indicator of desensitization. Moreover, this reduced brain response predicted participants’ aggression levels: the smaller the brain response to violent photos, the more aggressive participants were.

 

Participants who had already spent a lot of time playing violent video games before the study showed small brain response to the violent photos, regardless of which type of game they played in the lab.

 

“The fact that video game exposure did not affect the brain activity of participants who already had been highly exposed to violent games is interesting and suggests a number of possibilities,” Bartholow said. “It could be that those individuals are already so desensitized to violence from habitually playing violent video games that an additional exposure in the lab has very little effect on their brain responses. There also could be an unmeasured factor that causes both a preference for violent video games and a smaller brain response to violence. In either case, there are additional measures to consider.”

 

Bartholow said that future research should focus on ways to moderate media violence effects, especially among individuals who are habitually exposed. He cites surveys that indicate that the average elementary school child spends more than 40 hours a week playing video games — more than any other activity besides sleeping. As young children spend more time with video games than any other forms of media, the researchers say children could become accustomed to violent behavior as their brains are forming.

 

“More than any other media, these video games encourage active participation in violence,” said Bartholow. “From a psychological perspective, video games are excellent teaching tools because they reward players for engaging in certain types of behavior. Unfortunately, in many popular video games, the behavior is violence.”

 

The journal article, “This Is Your Brain on Violent Video Games: Neural Desensitization to Violence Predicts Increased Aggression Following Violent Video Game Exposure,” will be published in a forthcoming edition of the Journal of Experimental Social Psychology.

——————————–

This spiraling trend of increasing glorification of violence has got to stop if we want to reduce aggression and violence in our teenagers. Today’s culture, replete with MMA, UFC, Air Soft guns, COD, street fights and dehumanization of others threatens the very fabric of our society. Where does it end?

What are your thoughts? What do you think? Have we gone too far when we paint a picture of victory as ripping out your opponent’s spine and beating him to death with his own skull as in the new Mortal Kombat 9? At what point are we oversaturating our children with the message that violence is an acceptable solution to disagreement? I’d love to hear your opinion!

All the best,

John Schinnerer Ph.D.

Founder of Guide to Self

Anger management geek

For a free PDF copy of John’s award-winning book on anger, anxiety and depression, simply visit www.GuideToSelf.com click on the yellow book icon and enter your name and email address on the following page. You will be sent an email to verify your email address and then receive instant access to your book!  

University of Missouri-Columbia (2011, May 25). Violent video games reduce brain response to violence and increase aggressive behavior, study suggests. ScienceDaily. Retrieved May 26, 2011, from http://www.sciencedaily.com¬ /releases/2011/05/110525151059.htm

 

Upper-Class Has Difficulty Reading Emotions of Others

From the ubiquitous ScienceDaily.com… 

Upper-Class People Have Trouble Recognizing Others’ Emotions

ScienceDaily (Nov. 23, 2010) — Upper-class people have more educational opportunities, greater financial security, and better job prospects than people from lower social classes, but that doesn’t mean they’re more skilled at everything. A new study published in Psychological Science, a journal of the Association for Psychological Science, finds surprisingly, that lower-class people are better at reading the emotions of others.

The researchers were inspired by observing that, for lower-class people, success depends more on how much they can rely on other individuals. For example, if you can’t afford to buy support services, such as daycare service for your children, you have to rely on your neighbors or relatives to watch the kids while you attend classes or run errands, says Michael W. Kraus of the University of California-San Francisco. He co-wrote the study with Stéphane Côté of the University of Toronto and Dacher Keltner of the University of California-Berkeley.

To learn more about HOW to read emotions properly, visit http://www.GuideToSelf.com for a FREE copy of the award-winning book, Guide To Self: The Beginner’s Guide to Managing Emotion and Thought by U.C. Berkeley-trained emotion expert, John Schinnerer, Ph.D. Just share your email address and name for a free, instant PDF copy of the 216 page book!

One experiment used volunteers who worked at a university. Some had graduated from college and others had not; researchers used educational level as a proxy for social class. The volunteers did a test of emotion perception, in which they were instructed to look at pictures of faces and indicate which emotions each face was displaying. People with more education performed worse on the task than people with less education. In another study, university students who were of higher social standing (determined from each student’s self-reported perceptions of his or her family’s socioeconomic status) had a more difficult time accurately reading the emotions of a stranger during a group job interview.

These results suggest that people of upper-class status aren’t very good at recognizing the emotions other people are feeling. The researchers speculate that this is because they can solve their problems, like the daycare example, without relying on others — they aren’t as dependent on the people around them.

A final experiment found that, when people were made to feel that they were at a lower social class than they actually were, they got better at reading emotions. This shows that “it’s not something ingrained in the individual,” Kraus says. “It’s the cultural context leading to these differences.” He says this work helps show that stereotypes about the classes are wrong. “It’s not that a lower-class person, no matter what, is going to be less intelligent than an upper-class person. It’s all about the social context the person lives in, and the specific challenges the person faces. If you can shift the context even temporarily, social class differences in any number of behaviors can be eliminated.”

To life, love and laughter,

 John Schinnerer, Ph.D.

Founder of Guide to Self, Inc.

http://drjohnsblog.wordpress.com Hot blog on the latest in anger management tips, tools and tricks

@johnschin Follow john on Twitter

Story Source:
The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Association for Psychological Science.
________________________________________
Journal Reference:
1. M. W. Kraus, S. Cote, D. Keltner. Social Class, Contextualism, and Empathic Accuracy. Psychological Science, 2010; 21 (11): 1716 DOI: 10.1177/0956797610387613