How Depressives Surf the Web

….Our second major discovery was that there were patterns of Internet usage that were statistically high among participants with depressive symptoms compared with those without symptoms. That is, we found indicators: styles of Internet behavior that were signs of depressive people. For example, participants with depressive symptoms tended to engage in very high e-mail usage. This perhaps was to be expected: research by the psychologists Janet Morahan-Martin and Phyllis Schumacher has shown that frequent checking of e-mail may relate to high levels of anxiety, which itself correlates with depressive symptoms.

Another example: the Internet usage of depressive people tended to exhibit high “flow duration entropy” — which often occurs when there is frequent switching among Internet applications like e-mail, chat rooms and games. This may indicate difficulty concentrating. This finding, too, is consistent with the psychological literature: according to the National Institute of Mental Health, difficulty concentrating is also a sign of depressive symptoms among students.

OTHER characteristic features of “depressive” Internet behavior included increased amounts of video watching, gaming and chatting.


Is the ‘Wall’ Between Medicine and Public Health Crumbling?

Leaders and Alumni of the Robert Wood Johnson Foundation Clinical Scholars program are working to encourage collaboration between once-distant professions.

“When I was at the University of North Carolina,” says Desmond Runyan, MD, DrPH, “we used to say that the street that ran between the School of Medicine and the School of Public Health was the widest street in town.” In Runyan’s telling, it wasn’t the distance from curb to curb that was the barrier, it was what he and others have described as the “wall between medicine and public health.”

Runyan found his way around the barrier, earning an advanced degree in public health after finishing medical school. But he said that while pursuing his degree, he felt obliged to leave his “white coat and stethoscope at home, because in public health, one had the clear view that doctors were the problem, not the solution.” Runyan has since spent much of his career helping to deconstruct the metaphorical wall, and from his position as national program director of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program, he has observed—and contributed to—real progress.

In fact, many alumni of the Clinical Scholars program are doing the same—remaining mindful of friction between the two professions, but finding ways to bring them together in service of improving Americans’ health. By their own descriptions, the effort has a lot to overcome. The professions train in separate schools, have different missions, learn to focus on different aspects of similar problems, have different pay scales that can cause tensions, and more.

–Robert Wood Johnson Foundation

Do Female Veterans Differ From Males in their Psychological Health Needs?

Other scientists found that one year post-deployment, both males and females reported similar levels of PTSD and mental health symptoms. Results of this study also suggested that female veterans of current conflicts experience similar levels of combat exposure but don’t demonstrate greater risk for mental health difficulties related to this exposure compared to male veterans.

Finally, compared to their male counterparts seeking PTSD treatment, female OEF and OIF veteransappear more likely to be divorced or never married, less likely to be employed, less likely to have service-connected disability for medical disorders, and more likely to have lower benefits ratings for the same medical disabilities than male veterans. Clearly, emerging findings in this area of study underscore the importance of continued research to better understand how military women differ from men in their psychological health needs.

Women service members make up less than 20 percent of the military, but face multiple challenges. Not only do they face obstacles at times as minorities in their military careers, they also have to juggle family responsibilities vying for their time and attention. And although some military women feel they must appear to be super-human and show no signs of weakness to gain respect from their male counterparts, it’s a sign of strength to ask for help.

Posted by Dr. Kate McGraw, Defense Center of Excellence clinical psychologist

One Day at a Time: Supporting a Family Member With PTSD

The support of friends and family members is critical for service members experiencing symptoms of posttraumatic stress disorder (PTSD), especially when many service members choose not to get the help they need because of the stigma that surrounds psychological health care. Paul Ross, the author of this Navy Medicine Live blog postknows this firsthand. Read about how he helped his brother, a U.S. Army veteran, get the help he needed for his combat-related PTSD. And then explore the resources identified at the end of this post to support military members and those who support them.

When my kid brother left for Iraq he was just that — a kid. He returned home shattered inside. The “dark pit,” as he calls it, was hidden underneath his gruff, infantry-tattooed exterior. No one in our family could have predicted what he would experience or the after-effects that continue to haunt him today.

Many sailors, soldiers, Marines and airmen return from deployments with posttraumatic stress disorder. As a family member of a person suffering from PTSD, we must be strong for them in a variety of ways to help them combat the disorder. I received an up-close and personal look at how it can affect a person, when my younger brother came to live with me after separating from the U.S. Army.

–Posted by Corina Notyce, Defense Center of Excellence Strategic Communications

School Bullying: Extent of Legal Protections

What GAO Found

School bullying is a serious problem, and research shows that it can have detrimental outcomes for victims, including adverse psychological and behavioral outcomes. According to four nationally representative surveys conducted from 2005 to 2009, an estimated 20 to 28 percent of youth, primarily middle and high school-aged youths, reported they had been bullied during the survey periods. However, differences in definitions and questions posed to youth respondents make it difficult to discern trends and affected groups. For example, the surveys did not collect demographic information by sexual orientation or gender identity. The Departments of Education (Education) and Health and Human Services (HHS) are partially addressing the issue of inconsistent definitions by collaborating with other federal departments and subject matter experts to develop a uniform definition of bullying that can be used for research purposes. However, gaps in knowledge about the extent of bullying of youths in key demographic groups remain.

According to Education, as of April 2012, 49 states have adopted school bullying laws. The laws in the 8 states that GAO reviewed vary in who is covered and the requirements placed on state agencies and school districts. For example, 6 of the states cover a mix of different demographic groups, referred to as protected classes, such as race and sex or gender, in their bullying laws, while 2 states do not include any protected classes. With respect to school districts, each of the 6 districts GAO studied adopted policies that, among other things, prohibit bullying and describe the potential consequences for engaging in the behavior. Also, school district officials told GAO that they developed approaches to prevent and respond to bullying. For example, several school officials said they implemented a prevention-oriented framework to promote positive school cultures. Both state and local officials expressed concerns about various issues, including how best to address incidents that occur outside of school.

Federal civil rights laws can be used to provide protections against bullying in certain circumstances, but certain vulnerable groups are not covered and therefore have no recourse at the federal level. For example, federal agencies lack jurisdiction under civil rights statutes to pursue discrimination cases based solely on socioeconomic status or sexual orientation. While some state civil rights laws provide protections to victims of bullying that go beyond federal law, federal complainants whose cases are dismissed for lack of jurisdiction are not always informed about the possibility of pursuing claims at the state level.

Three federal departments—Education, HHS, and the Department of Justice (Justice)—have established coordinated efforts to carry out research and broadly disseminate information on bullying to the public, including establishment of a central website and an informational campaign to raise awareness about bullying. In addition to these efforts, Education has issued information about how federal civil rights laws can be used to address bullying of protected classes of youths and is conducting a comprehensive study of state bullying laws and how selected school districts are implementing them. However, no similar information is being gathered on state civil rights laws and procedures that could be helpful in assessing the adequacy of legal protections against school bullying.

Why GAO Did This Study

Millions of youths are estimated to be subject to bullying in U.S. schools. GAO was asked to address (1) what is known about the prevalence of school bullying and its effects on victims, (2) approaches selected states and local school districts are taking to combat school bullying, (3) legal options federal and selected state governments have in place when bullying leads to allegations of discrimination, and (4) key federal agencies’ coordination efforts to combat school bullying. GAO reviewed research on the prevalence and effects on victims; analyzed state bullying laws, and school district bullying policies; and interviewed officials in 8 states and 6 school districts. States were selected based on various characteristics, including student enrollment, and their definitions of bullying. Also, GAO reviewed selected relevant federal and state civil rights laws, and interviewed officials from Education, HHS, and Justice.

What GAO Recommends

GAO recommends that Education compile information about state civil rights laws and procedures that relate to bullying, and inform complainants about state legal options; Education, HHS, and Justice develop information about bullied demographic groups in their surveys; and assess whether legal protections are adequate for these groups. Education disagreed with our first recommendation and we clarified it to address some of their concerns. Education is considering our second recommendation, agreed with our third, and provided information on efforts related to the last. HHS agreed with our recommendations. Justice did not provide a written response.


–U.S. Government Accountability Office

Gluten Sensitivity in Mothers Linked to Psychosis in Offspring

by Barbara Boughton

June 14, 2012 — High levels of maternal antibodies to gluten in pregnant women may be linked to the development of nonaffective psychosis in their children in later life.

Investigators from the Karolinksa Institute, in Stockholm, Sweden, found that levels of immunoglobulin G (IgG) higher than the 90th percentile in the maternal circulation were associated with nonaffective psychosis in offspring in adulthood.

“To our knowledge, this is the first study to show an association between high levels of maternal antibodies directed at gliadin [a component of gluten] and the later development of nonaffective psychosis,” the researchers, led by Håkan Karlsson, PhD, write.

The study is published in the June issue of the American Journal of Psychiatry.

Caution Warranted

Previous studies have linked maternal malnutrition or infections with development of schizophrenia and other nonaffective psychoses.

Also, other studies have shown immune activation at the time of the first symptoms of nonaffective psychosis, the investigators note.

However, the current study is the first to assess whether antibodies to dietary antigens in blood samples taken from mothers at birth might be linked to the development of nonaffective psychosis in adult offspring.

Although the findings raise interesting questions, its data are preliminary and should not be considered proof of a link between gluten sensitivity in mothers and psychosis in children, one expert said.

“My concern is that there is a big epidemic of anxiety about gluten right now,” said Nada Stotland, MD, MPH, past president of American Psychiatric Association and professor of psychiatry at Rush Medical College, in Chicago, Illinois, in an interview with Medscape Psychiatry.

“I’m very concerned about any information that might cause frenzy among pregnant women who are already worried about environmental and dietary factors affecting their children,” Dr. Stotland said.

Another Piece of the Puzzle

In the study, researchers analyzed the presence of antibodies to dietary antigens in blood samples collected from pregnant women who gave birth between 1975 and 1985 in Sweden.

The levels of antibodies to dietary antigens in birth mothers’ blood were compared for 211 participants with nonaffective psychosis to such levels in 553 people without mental illness.

The participants were treated in hospitals or as outpatients in Sweden between 1987 and 2003; the 553 control participants were selected from a population-based medical birth registry in Sweden. Blood samples from birth mothers collected for the same birth registry were used for the analyses.

Results indicated that high levels of IgG antigliadin antibodies from the birth mothers were associated with a significantly elevated risk for nonaffective psychoses in their offspring.

The researchers also assessed the presence of antibodies to casein, an ingredient in milk, in the mothers’ blood — but they did not find a significant association with the development of nonaffective psychosis in offspring (odds ratio [OR], .8; 95% confidence interval [CI], .4 – 1.5).

“This is exciting research because every piece of the puzzle that leads to our understanding of psychosis is welcome. These are important questions because psychotic disorders have the potential to ruin people’s lives and stress families very severely,” Dr. Stotland said.

“Autoimmune factors and their influence on psychosis have not been studied that much,” she added.

Yet, to truly know whether dietary factors are important in the development of psychosis will take many more studies and clinical trials, she noted.

Dr. Kårlsson and Dr. Stotland have disclosed no relevant financial relationships.

Am J Psychiatry. 2012;169:625-632. Abstract

July 16 –St. Paul, MN Parity Field Hearing


for a


The Honorable Betty McCollum

The Honorable Keith Ellison

The Honorable Patrick Kennedy

The Honorable Jim Ramstad

Dave Wellstone


The Honorable Al Franken

At the field hearing, state and local representatives, providers and consumers will speak about parity implementation and enforcement.

JULY 16, 2012


Minnesota Recovery Connection

253 State Street

St. Paul, MN