- high quality schools
- safe neighborhoods and workplaces
- a cleaner environment
- reducing poverty
- desegregating our health care system
- protecting and nurturing the physical, mental and social development of children under the age of 5
- empowering communities to solve problems
- imposing stricter tobacco control standards
- providing health care for legal immigrants who are ineligible for Medicaid the first five years they are in the U.S.

Veterinarians in Australia have one of the highest expected suicide rates among other professions. A study in the Australian Veterinary Journal published by Wiley-Blackwell finds that vets are four times more likely to commit suicide as compared to the general adult population- thus highlighting the need for a thorough investigation into the rate of suicide and its contributing factors.

The study entitled “Suicide in Australian Veterinarians” is the first published study to report on actual suicide rates for this professional group. The researchers examined official records for the causes of death when ascertaining actual suicide numbers and behavioral patterns among vets.

Lead author Dr. Helen Jones-Fairnie of Curtin University in Perth, Australia says, “While doctors and dentists are among professional groups that have been cited to have high suicide rates in Australia, there are currently no published studies reporting the actual suicide rates among Australian vets, and no official comparison of these rates against other professional groups.”

“In view of the apparently high suicide rate among veterinarians, further research using the total Australian population should be undertaken. In addition, accurate data on which statistics are based on are also needed to allow informed judgments and appropriate response to be made”, said Dr. Jones-Fairnie.

She added, “A more representative sample is needed to determine if the suicide rate is as high as indicated and if stress and depression play a contributing role to suicide. In the meantime, the dissemination of information about distress and suicide should be balanced with advice on how to alleviate distress among veterinarians and where to obtain the most appropriate support and mentoring.”

A new study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) presents results on the first onset of substance use disorders (i.e., alcohol and drug abuse and dependence) and major mood and anxiety disorders, based on Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

This landmark survey is the first conducted in the U.S. to identify rates of first episodes (i.e., incidence) of these disorders in the U.S. population. In addition, it provides information on sociodemographic and psychopathologic risk factors for those disorders – information critical for developing evidence-based preventive interventions – and estimates risk for subsequent comorbid disorders.

Bridget Grant, Ph.D., Chief of NIAAA’s Laboratory of Biometry and Epidemiology, and her colleagues found that 1-year incidence rates were highest for DSM-IV alcohol dependence (1.70%), alcohol abuse (1.02%), major depressive disorder (1.51%) and generalized anxiety disorder (1.12%), followed by panic disorder (0.62%), bipolar I disorder (0.53%) and specific phobia (0.44%). One-year incidence rates of DSM-IV social phobia (0.32%), bipolar II (0.21%) and drug abuse (0.28%) and drug dependence (0.32%) were lower but not insignificant. These rates are comparable to or exceed corresponding incidence rates for other common medical diseases such as lung cancer (0.06%), stroke (0.45%) and cardiovascular disease (1.5%).

The study found that men were at greater risk of first onset alcohol abuse, alcohol dependence and drug dependence, and 1-year incidence rates were greatest among 20- to 29-year-olds and individuals who had been separated/divorced/widowed or never married. By contrast, the risk of most incident DSM-IV anxiety disorders, including panic disorder, specific but not social phobia, and generalized anxiety disorder, was greatest among women, and all anxiety disorder incidence rates were greater in the youngest age groups (20- to 54-year-olds). Among DSM-IV mood disorders examined in this study, the risk of first onset of major depressive disorder (MDD) was greatest among women, and no sex differences in incidence were found for bipolar I and II disorders. Taken together, these results highlight age as an important general risk factor for first onset DSM-IV substance use, mood and anxiety disorders, whereas the effects of sex and marital status appear to be disorder-specific.

Consistent with earlier studies, baseline dysthymia in this study predicted incident MDD, and baseline MDD predicted incident bipolar II disorder, suggesting that MDD precedes hypomania in the development of bipolar II disorder. Consistent with other prospective studies, alcohol abuse and dependence showed strong reciprocal temporal relationships, whereas drug abuse predicted only incident drug dependence. “The reciprocal relationship between alcohol abuse and dependence suggests that strong common factors may underlie the relationship and provides support for eliminating the hierarchy between the disorders in future DSM revisions,” state the authors. Other intriguing findings include reciprocal temporal relationships between MDD and GAD, and GAD and panic disorder, suggesting that common causes underlie those disorders. In addition, substance use disorders did not predict any incident mood or anxiety disorder, the authors note.

“Information on psychiatric risk factors prospectively identified in this study can begin to inform a new class of preventive interventions aimed at preventing a second disorder or set of disorders,” said Grant. “As to clinical implications, this study helps to clarify the risk of future disorders posed by chronologically primary disorders, information that may be used to improve treatment planning and counsel patients at risk of developing secondary disorders.”

Stereotypes can boost as well as hinder our chances of success, according to psychologists from the University of Exeter and St Andrews University. Writing in the new edition of Scientific American Mind (out in the UK 22 April 2008), they argue that the power of stereotypes to affect our performance should not be underestimated.

Drawing on a large body of research, the authors argue that success or failure at work, at school or in sport cannot always be attributed solely to ability or incompetence. Studies suggesting that gender or race can play a part in performance have proved controversial. The researchers argue that the roots of such handicaps lie partly in the preconceptions that other people hold about these groups. For example, a woman who has been led to believe that women generally do worse than men at mathematics, will perform less well in a maths test as a result. Following a similar logic, in the sporting domain, one reason why the England football team performs badly in penalty shoot-outs (winning only 1 of 7 in major tournaments) is that performance is impeded by knowledge of stereotypes associated with a history of failure.

However, the researchers also point out that stereotypes can have positive dimensions that are able to boost individual or group’s performance. For example, research has shown that Asian women do better on maths tests if they identify themselves as Asian rather than as women. Another study has shown that white golfers tend to perform better against black opponents if they are told that they are being judged on their “sport strategic intelligence” than if they are told they are being tested on their “natural athletic ability.”

“The power of stereotypes should not be underestimated. What we think about ourselves – and also, what we believe others think about us – determines both how we perform and what we are able to become,” said Professor Alex Haslam of the University of Exeter. “As well as holding people back, stereotypes and preconceptions can boost both individual and group performance. For example, if you belong to a group that is always exposed to the message ‘we are the best’, this can promote personal achievement. While we’re often told “believe in yourself”, it can actually be more beneficial to focus on beliefs about your group, as group identity is a powerful vehicle for both personal and social change.”

The authors argue that minorities can overcome their disadvantages by changing external perceptions of their group. The article highlights the flexibility of stereotypes and argues that rather than being fixed, they are very sensitive to change. Professor Stephen Reicher of St Andrews University commented: “In many ways our stereotype of the stereotype is wrong. Stereotypes are neither fixed, nor necessarily harmful. Indeed, in our own hands, they can be tools of progress”. As the authors note, it was precisely by challenging stereotypes that activists like Steve Biko and Emmeline Pankhurst were able to achieve emancipation for black South Africans and British women.

If you clean your house vigorously for twenty minutes non-stop once a week, your anxiety, distress or depression may improve, according to a study published in the British Journal of Sports Medicine.

The study also stresses that any type of vigorous physical exercise, sustained for a 20-minute period can have a good impact on your mental health. The scientists, from University College London, say that the more vigorous and frequent the activity, the greater the impact.

The study examined a survey of 20,000 men and women who were quizzed for the Scottish Health Survey about their state of mind and how much weekly physical activity they engaged in. Over 3,000 participants were deemed to be suffering from stress and/or anxiety. They found that people who did sports at least once a week were 33% less likely to suffer from mental health problems. Those who did vigorous housework once a week regularly were 20% less likely to suffer from mental health problems. This drop in risk held even after taking into account such factors as age, gender, and the presence of a long term condition.

The researchers stressed that vigorous housework does not include some little light dusting. As well as lasting at least 20 minutes, the activity has to make you feel at least slightly breathless.

The scientists explain that physical activity reduces inflammation, glucose intolerance and cardiovascular problems, all biological factors which are linked to depression risk. They believe these biological factors are probably key to helping physically active people enjoy better mental health. On the other hand, they accepted that it is possible it might be the other way round – people with mental health problems perhaps do not exercise as much.

Mark Hamer, University College London, research team member, explained that several studies seemed to show a link between better mental health and physical activity. This is the first study that quantifies the amount of activity needed to have an impact. He added “But it is a chicken and egg issue – as those who suffer from stress or anxiety may be less likely to take part in physical activity in the first place.”

“Dose-response relationship between physical activity and mental health: the Scottish Health Survey.”
Online First Br J Sports Med 2008; doi 10.1136/bjsm.2008.046243

Anytime after 30, hopefully as late as 40 or 45, some of that muscle we were so proud of begins to be replaced with fat. Where that fat is most likely to accumulate is around our middles. Even if we are the same weight we were 10 years earlier, gradually we begin to notice the development of a “spare tire” or “love handles;” namely, just plain “belly fat.”

When we were younger, our bodies produced hormones: estrogen in women, testosterone in men. These hormones helped regulate the “flow” of fat, spreading it to our arms, legs, and hips. As we age, those hormones are no longer being produced, and fat starts to accumulate more deeply inside our bodies, most notably around our middles.

The purpose of body fat is that it helps to regulate our body’s temperature and it also provides shock absorption for our bones and organs, and if we were forced to fast for a long period of time, it would supply food to maintain our bodily functions. The layer of fat closest to our skin is called subcutaneous fat. It poses no health threat, unless we are obese.

The fat that resides deeper in our bodies is called visceral fat, and it can harm us. This visceral fat, later in life, tends to collect around our tummies, and creates the spare tire effect. It can interfere with liver function, and the processing of cholesterol and insulin, and is associated with an increased risk for diabetes, heart disease, and even some forms of cancer.

Holly St. Lifer, a health and fitness writer, wrote an article titled “How to Lose Your Spare Tire,” which appeared in the July/August 2007 edition of the AARP magazine. She gives us some useful suggestions about how to better keep our youthful figures, and especially how to prevent the build-up of excessive belly fat.

It’s no surprise that we need to first eliminate what Ms St. Lifer calls the “five C’s: candy, cookies, cake, cola, and chips.” She also suggests limiting fried foods to once a month, and warns against heavy indulgence of any snack foods like chips, crackers and processed breads.

That’s the easy part of how to avoid a spare tire. The going gets rougher from there. Regular, at least moderate, exercise needs to play a big role in our daily schedules. Strength training and aerobic exercise are especially effective to stem the growth of belly fat.

Strength training can work all your major muscle groups: arms, shoulders, chest, abs, back and legs. Researchers found that it reduced belly fat by 10 to 15 percent in two groups of 50 to 70 year olds, even when there was no weight loss. Increase the length of your workout slowly. If you increase the weight you are working with more than 5 to 10 percent every couple of weeks you will risk undue strain on your muscles, tendons and ligaments.

If you are trying to not only lose weight, but to also lose more fat than you would through just through dieting, aerobic exercise can be the solution. St. Lifer’s article stated that “research from the University of Arkansas found that study participants who did 90 minutes of moderate exercise, five days a week, lost twice the amount of visceral fat as those who just dieted.” A study published in the Journal of the American Medical Association in 2003 found that participants who moderately exercised 90 minutes a day, five days a week lost 3 to 6 percent of their belly fat, while those who only dieted lost just half that amount.

Exercise works, and the more you exercise, the more it works. You might start at 30 minutes a day, or 30 minutes at least several times a week. Work up until you can comfortably exercise for an hour, three to five times a week. If all that is too much for you, start by walking a half hour a day, every day. Remember, we have to start somewhere and you are only in competition with yourself.

Researchers at the University of British Columbia and the Harvard Business School have found that it’s possible to buy happiness after all: when you spend money on others.

In a series of studies, UBC Asst. Prof. Elizabeth Dunn found that individuals report significantly greater happiness if they spend money “pro-socially” – that is on gifts for others or charitable donations – rather than spending on themselves. Her findings will appear in the March 21 edition of the journal Science.

“We wanted to test our theory that how people spend their money is at least as important as how much money they earn,” says Dunn, who teaches in the UBC Dept. of Psychology and is lead author of the study.

Her co-authors are UBC master’s student Lara Aknin and Michael Norton, an assistant professor at the Harvard Business School.

The researchers looked at a nationally representative sample of more than 630 Americans, of whom 55 per cent were female. They asked participants to: rate their general happiness; report their annual income; and provide a breakdown of their monthly spending, including bills, gifts for themselves, gifts for others and donations to charity.

“Regardless of how much income each person made,” says Dunn, “those who spent money on others reported greater happiness, while those who spent more on themselves did not ”

The study also measured the happiness levels of employees at a firm in Boston before and after they received their profit-sharing bonus, which ranged between $3,000 and $8,000.

What affected the employees’ happiness, says Dunn, was not so much the size of the bonus but how they spent it.

The employees who devoted more of their bonus to gifts for others or toward charity consistently reported greater benefits than employees who simply spent money on their own needs.

In another experiment, the researchers gave participants a $5 or $20 bill, asking them to spend the money by 5 p.m. that day. Half the participants were instructed to spend the money on themselves, and half were assigned to spend the money on others. Participants who spent the windfall on others reported feeling happier at the end of the day than those who spent the money on themselves.

“These findings suggest that very minor alterations in spending allocations – as little as $5 – may be enough to produce real gains in happiness on a given day,” says Dunn.

I drink coffee. Here is a research about coffee container. Source: Aradhna Krishna and Maureen Morrin, “Does Touch Affect Taste? The Perceptual Transfer of Product Container Haptic Cues.” Journal of Consumer Research: April 2008.

Does coffee in a flimsy cup taste worse than coffee in a more substantial cup? Firms such as McDonalds and Starbucks spend millions of dollars every year on disposable packaging, but a new study from the April issue of the Journal of Consumer Research suggests that trying to skimp in this area might not be worth it – and may negatively impact consumers’ perceptions of taste and quality.

In a series of four experiments, Aradhna Krishna (University of Michigan) and Maureen Morrin (Rutgers University) find that many people do indeed judge a drink by its container. Specifically, the firmness of a cup seems to have an impact on consumer evaluations of the beverage contained inside.

“We found that the nondiagnostic haptic qualities of a product package or serving container can affect how a product is evaluated; that is, such cues can indeed have an effect on product evaluation,” the researchers write.

Not everyone has the same sensitivity to touch, though, the researchers explain. They first performed a pretest to determine which participants were strong autotelics – the sort of people who like to touch things before they buy them – and which participants were not particularly inclined to touch products (low autotelics).

Participants then evaluated the feel of the cups while blindfolded or in an evaluation in which they could both feel and see. Perhaps unsurprisingly, the largest difference in ratings for the firm and the flimsy cups was in the blindfolded condition among those most sensitive to touch.

However, the researchers also found that those who like to touch are least influenced by touch in taste evaluations. Indeed, in a taste test of the same mineral water from both a flimsy and a firm cup, it was low autotelics who gave the most negative evaluations of the taste of the water in the flimsy cup.

The results were similar when participants were just told about the containers in a written description and did not actually feel them: Low autotelics expressed a willingness to pay more for a firm bottle of water, while high autotelics did not.

The researchers explain: “High (vs. low) autotelics receive more pleasure from touching objects, tend to touch them more, and are more consciously aware of the potential effect of haptic clues on product judgment. As a result, they are more capable of adjusting for such clues in their product judgments when they are nondiagnostic in nature.”

Massachusetts College of Pharmacy and Health Sciences, which last year successfully launched the region’s first Master of Applied Natural Products Degree program, has announced it plans to offer a Blended/Online Master of Applied Natural Products degree program in Fall 2008. It is targeted at working professionals with a baccalaureate degree in a health-related field.

“The Master of Applied Natural Products is an important program for the future of the U.S. medicine, as it bridges the worlds of conventional healthcare and the traditions and science of natural products,” said Lana Dvorkin-Camiel, PharmD, Associate Professor of Pharmacy Practice and Director of the Applied Natural Products Program. “Society needs a new generation of clinicians that will respond to increased demand by becoming experts in revitalizing practice, research and education in the area of natural products.”

The program can be completed in as little as five semesters, most of which will combine five-day, on-campus intensive experiences with the convenience of online course work. The professional education will focus on therapeutics of natural products/herbal and dietary supplements, natural products informatics, principles of functional medicine and epidemiology. Clinicians will also gain skills necessary for finding and evaluating relevant information and continuing lifelong learning.

Massachusetts College of Pharmacy and Health Sciences, Boston’s oldest college, is a private, coeducational institution offering graduate, professional and undergraduate degrees in the health sciences. With campuses in Boston, Worcester, and Manchester, New Hampshire, the College enrolls approximately 3,800 students, who are drawn from 35 states and 34 foreign countries, and employs over 350 faculty and staff.

By Martin E.P. Seligman, PhD
APA President

My main campaign promise, to see that the funding to launch major studies on the effectiveness of therapy is made available, has been fulfilled. The National Institute of Mental Health (NIMH) has agreed to fund such studies on a massive basis. Effectiveness research promises to be a significant aid in the fight against profit-driven health schemes for the treatment of mental illness in the next century.

The distinction between an efficacy study and an effectiveness study is crucial. An efficacy study is a laboratory distillation of treatment. Efficacy studies consist of a brief and fixed duration of therapy, manualized treatment, a single simple disorder and random assignment of clinic volunteers to type of treatment. Efficacy studies have generally shown that under such well-controlled conditions a brief course of specific psychotherapy or of medication works reasonably well for a variety of disorders. Such studies have good internal validity, but their findings can generalize poorly to treatment as it is actually done in the real world. Effectiveness studies such as the well-known Consumer Reports study, on the other hand, look at the outcome of treatment as it is actually delivered in real life. Treatment is not necessarily brief or of fixed duration. It is determined by the clinician?s judgment, the patient?s decision, progress toward goals, and life changes. There is no manual to follow, and the therapist can adjust tactics to accord with the patient?s progress. Disorders are complex, and patients choose a type of therapy they believe in and choose a therapist they believe will help them.

The results of effectiveness studies differ in several crucial ways from the results of efficacy studies: First, there seems to be substantially more patient improvement in effectiveness studies. Second, there seems to be little specificity of the type of therapy or drug for any disorder in effectiveness studies, but high specificity in efficacy studies. Third, effectiveness studies robustly document that the longer the therapy, the more improvement on every outcome variable. Fourth, effectiveness studies show that health-care plans that limit duration of therapy hurt the outcome of therapy.

It is these discrepancies that have led the National Institute of Mental Health under the leadership of Steve Hyman, MD, Grayson Norquist, MD, and Barry Lebowitz, PhD, to sponsor a major new program of outcome research. No dollar figure has yet been announced, but there is reason to believe that at least $20 million a year will be spent. Managed care is now deeply cutting the quality of mental health services in order to make money, and there is no adequate data to bridle such cuts. Efficacy studies, suited only to testing brief and inexpensive treatments, can only bolster the use of brief and inexpensive treatments. The existence of a definitive body of effectiveness research, however, is likely to complement efforts currently under way to ensure that the health-care marketplace considers quality as well as cost issues. This is not a short-term fix for the present health-care crisis. This is the long-term solution.

What will happen next? In the next year we will see a call for proposals for effectiveness research on psychotherapy and drugs. Fierce competition for the research dollars will ensue, and NIMH?s standards will be very high. The outcome of that competition will be crucial to the future of psychotherapy. It is often the case that the question asked determines the answer given. If drug researchers get these grants, it is likely that 10 years from now we will see guidelines that tell us that drugs are the treatments of choice. If managed-care companies and their researchers get these grants, this will further fuel their effort to recommend the least expensive and briefest of treatments.

If, however, our science and practice communities now come together to do this research, the outcome is likely to be optimal for our providers and for our patients. The Science and Practice directorates are working together to communicate with NIMH about possible collaborative efforts.

At the initiative of Bob Brown of the Board of Professional Affairs, there was a recent meeting of Science and Practice Directorate staff, several members of BPA, the Committee for the Advancement of Professional Practice (Ron Fox, chair) and the Board of Scientific Affairs (Paul Sackett, chair). They agreed that a planning meeting this spring?followed by a larger working group meeting in the fall including APA and NIMH staff, practition-ers and methodologists?would be useful to develop these initiatives.

All of the following can now be targets of discussion between APA and NIMH: well-funded statewide practice research networks, conferences to broaden and deepen the assessment of outcomes beyond mere symptoms of disorder, summer workshops to train a new cohort of researchers in effectiveness methodology and in effectiveness-efficacy hybrid designs, collaborations between psychoanalytic therapists and outcome scientists, the investigation of doctoral-level training in the outcome of treatment and of psychologists in primary care, effectiveness of psychological care in the relief of physical illness, and the role of large-scale preventive programs on the mental health of the nation.

This is a splendid opportunity for science and practice to work together, the best opportunity that I have seen in my lifetime.

The effectiveness of therapy