Sense of Fatalism Encourages Risky Behavior in Teens

A surprising number of teens expect to die young. In a seven-year study of 20,000 teens in grades 7 through 12, 15% felt it was highly likely that they would die before they reached their 35th birthday. Published in the July issue of Pediatrics, the unexpected results have caused researchers at the University of Minnesota to wonder if it is a feeling of hopeless fatalism rather than a sense of invulnerability that leads teens to engage in risky behavior.

The magnitude of teen-aged pessimism took researchers by surprise. University of Minnesota researcher Dr. Iris Borowsky told the Associated Press, Adolescence is “a time of great opportunity and for such a large minority of youth to feel like they don’t have a long life ahead of them was surprising.”

Males (15%) were slightly more likely than females (13%) to think they would die young. Living in a more stable family situation appeared to decrease the feeling of risk. Only 10% of teens who lived with both biological parents felt at risk, while 18% of those who lived with only one or neither of their biological parents felt they would die early. Lack of financial stability significantly increased the feeling of risk. Twenty-four percent of teens with a parent receiving public aid believed they would die at an early age. Racially and ethnically, the breakdown of perceived risk of early death was highest for groups exposed to the greatest deprivation and violence:

• 30% Native American
• 26% Black
• 21% Hispanic
• 15% Asian/Pacific Islander
• 10% White

While fatalistic teens did not die more often than their more optimistic peers (only 94 of the 20,000 teens participating died during the seven-year study), they were more likely to engage in unsafe behavior, including drug and alcohol abuse, unprotected sex, attempted suicide, and getting into fights that resulted in serious injury. Teens who believed they would die young were seven times more likely to contract AIDS than their positive-thinking peers. The perception that life was hopeless appears to have encouraged greater risk taking.

Psychiatrists are looking at the study in hopes of developing better methods for identifying at risk teens. It is hoped that the detection of fatalistic attitudes and thinking will help the medical community identify and treat at risk teens before they engage in dangerous behavior.

Couch Time Causes Insomnia in Children

Many school-age children experience trouble falling asleep. As many as 16% of parents report having problems getting their children to fall sleep at night. Researchers say the solution could be as simple as getting more physical exercise during the day.

The amount of physical activity children receive during the day plays an important role in childhood sleep patterns, according to a study recently published in Archives of Disease in Childhood. Researchers at the University of Auckland in New Zealand found that inactivity can lead to insomnia in children. Too many hours on the couch playing video games, watching television shows or movies, even reading made it harder for children to fall asleep and stay asleep. Researchers found that it took children three extra minutes to fall asleep at night for every hour they spent engaged in sedentary activities during the day.

In the largest study of its kind, researchers compared the activity and sleep patterns of over 500 seven-year-olds. It took children from 13 to 42 minutes to fall asleep with 26 minutes being the average. Children who engaged in sedentary pursuits like TV watching and video games during the day took the longest to fall sleep. As physical activity increased, the amount of time it took for children to enter dreamland shortened. Those who were the most physically active during the day fell asleep the fastest and also slept the longest.

“These findings emphasize the importance of physical activity for children, not only for fitness, cardiovascular health and weight control, but also for promoting good sleep,” the researchers concluded.

Researchers found that parents universally overestimated the amount of time their children spent falling asleep. On average it took children 15 minutes longer to fall asleep than parents indicated on study surveys. Television and video games can over-stimulate children, making it harder for them to fall asleep. Limiting such activities in the evening can promote better sleeping habits. But healthy, physical exercise during the day is the key to tiring out energetic youngsters so they can fall asleep at night. Children who get adequate sleep at night (8 to 10 hours) do better in school and are less likely to become obese.

Preparing Your Child for Summer Camp

Sleepover camp is a major childhood rite of passage. For many children it’s their first experience being away from parents and home. The familiar people, surroundings and activities that anchor life and provide belonging and stability are suddenly gone. While some children thrive in new environments and find making friends and trying new activities exciting, others grow anxious and can become distraught. Homesickness can turn summer camp into a trying experience for children and their parents.

Most children feel a few twinges of homesickness when they go away to camp. The challenge of making friends, a difference of agreement with another child, a reprimand from a counselor, difficulty excelling at camp activities – experiences that bruise the child’s ego or make him feel unsure of himself often engender a desire to return to the safety of home. For some children, the drastic change in environment and routine can be unsettling and upsetting. Sharing a room, interacting with new adults, unfamiliar foods, insects, camp bathrooms — so many new experiences at once push some children into emotional overload.

Parents can help their children prepare to cope with homesickness before they leave for summer camp. In the years leading up to overnight camp, expose your children to other adults, new friends, new activities and time away from parents and home. Encourage your children to participate in sports, dance classes, music lessons, scouts and other activities. Sign them up for park district, scout or sports day camps. Allow them to sleep over at friends’ and relatives’ homes.

Before camp, talk to your children about homesickness. Explain that feeling homesick is normal and that activities and making new friends will distract them from feeling sad or nervous. Let them take a talisman from home with them — a stuffed animal, family photo or other comforting item. Encourage them to write letters sharing their camp experiences and write to them. Write a cheerful letter before they leave, timing it to arrive the first or second day of their stay. Always be positive, encourage your child not to give up, and reassure your child that you know he can handle being away from home.

Is Your Child Addicted to Computer Games?

School is out and the long summer stretches ahead. It should be a time for outdoor fun, playing with friends, baseball games, reading, craft projects and lemonade stands; but many children spend their summers glued to the computer, playing games on the Internet for hours on end. Gaming, which seems to be particularly appealing to males, can be addictive. While the subject is still under study, gaming seems to trigger compulsive behaviors in some people.

It can be difficult to tell whether a child’s competitive interest in gaming has crossed the line into internet addiction. The following warning signs can indicate a problem:

• Your child loses track of time while on the computer.
• He’d rather play computer games than play with friends or engage in other activities that have interested him in the past.
• You child neglects chores and other responsibilities.
• Your child lies to you about his computer use, changes the screen quickly when you walk into the room or sneaks computer time.
• He talks constantly about games, game personas and strategies.
• Your child becomes irritable or rebellious when told to turn off the computer.

Gaming and overuse of computers has been cited as contributing to feelings of social isolation and loneliness, particularly in teens. It can exacerbate anxiety and depression and may trigger obsessive compulsive behaviors. Experts fear that the sedentary aspect of gaming is contributing to an increasing array of physical health problems, like obesity, among U.S. children.

If you feel your child has a problem with computer gaming, you will have to help him modify his behavior:

• Monitor computer use. Keep the computer in a common area so you can keep track of Internet activity.
• Set clear limits for realistic computer use; for instance, allowing gaming for a set period of time each day.
• Talk to your child. Gaming can mask underlying issues like an inability to fit in at school, bullying, depression or other emotional problems.
• Help your child replace gaming with healthy activities such as team sports, scouts, hobbies and clubs. Encourage social interaction with peers.

If you don’t see improvement, your child may need professional psychiatric help to end his dependence on computer games. Cognitive-behavioral therapy can helping children successfully stop compulsive Internet behaviors and learn to live a happy, well-balanced life.

Can Insomnia Be Inherited?

A new study presented at Sleep 2009, the 23rd Annual Meeting of the Associated Professional Sleep Studies, suggests that insomnia may be inheritable. The study of 1,436 eight- to 16-year-old twins found that the same genes that impact depression and anxiety affect adolescent insomnia. Study results are consistent with the results of similar studies connecting insomnia to depression and anxiety in adults. Shared genetic effects suggest a probable genetic link between the three disorders.

According to an online article posted on the Science Blog, lead author Phillip Gehrman, assistant professor of psychiatry at the University of Pennsylvania School of Medicine, said researchers had expected to find a sleep-specific genetic indicator and were surprised to instead find a shared indicator with depression and anxiety. A number of previous studies have indicated a causal connection between insomnia and depression/anxiety. Chronic insomnia can lead to the development of depression or anxiety, and depression or anxiety can cause insomnia. The discovery that the same genetic effect links all three conditions sheds new light on their interconnectedness.

Periodic sleeplessness is normal, generally lasting only a few days and going away on its own without treatment. However, more intense levels of insomnia lasting several weeks can be triggered by stress. Such chronic insomnia will not go away without treatment and can cause serious short- and long-term health problems when left untreated. If you or your child exhibit chronic insomnia — sleep problems that last for more than a week — you should be screened for depression and anxiety. Likewise, those diagnosed with depression or anxiety may also need to be treated for insomnia. 

In another study reported at Sleep 2009, cognitive behavioral therapy was shown to help alleviate chronic insomnia. By learning to identify thoughts and patterns that interfered with sleep, nearly 60% of study participants aged 14 to 81 were able to alleviate insomnia and decrease or stop using sleep medication. Even when depression and anxiety exacerbate insomnia, researchers found cognitive behavioral therapy to be an effective method of treating chronic insomnia. To find out more about cognitive behavioral therapy, visit the Marks Psychiatry website.

Fidgeting Helps ADHD Students Succeed

Children seem to be in constant motion. Parents are forever admonishing their children to sit still. But for children with attention-deficit hyperactivity disorder (ADHD) the constant fidgeting isn’t in their parents’ imagination. Even when other children are able to remain focused and quiet, children with ADHD are compelled to fidget and twitch and squirm. Parents and teachers often respond by trying to get them to stop moving, thinking that if they can just still their bodies, their minds will be able to focus and learn.

A recent study by Mark Rapport, a psychology professor at the University of Central Florida in Orlando, suggests that it might be more effective to encourage ADHD children to fidget as much as they need to. Rapport spent four years meticulously recruiting, screening, and testing 23 boys aged 8 to 12. In a lengthy analysis of the results, Rapport found that ADHD children use movement to stay focused. Fidgeting may actually facilitate learning in children with ADHD. Just like the caffeine in coffee helps adults stay focused, jiggling, bouncing at their desks, swiveling in their chairs, swinging their feet, etc. may help ADHD children concentrate and do better in the classroom.

Children with ADHD, which affects 3% to 5% of U.S. children, have problems with short-term, or working memory, the part of the brain that temporarily stores the information needed to carry out immediate tasks. ADHD children process information differently than those without the disorder. A child without ADHD can remember and follow a series of brief directions like opening a book, turning to a certain page, and doing specified exercises. Children with ADHD lose focus part way through the instructions. They may only catch one or two in the series of instructions and wind up lost in the classroom.

Stimulants like Ritalin can augment short-term memory, making it easier for ADHD children to focus on tasks. But not all children respond equally to Ritalin, and some parents would prefer a drug-free solution. Rapport’s study, though small in scope, offers new methods for helping ADHD children focus in the classroom and succeed at school.

Parents’ Anxiety Can Affect Children

When parents suffer emotional problems, those problems can affect their children. Children who have a parent suffering from an anxiety disorder are also likely to exhibit anxiety. In a new study, researchers at Johns Hopkins Children’s Center have found that family counseling has the ability to prevent anxiety disorders in the children of parents with anxiety disorders.

In a small-scale study to be published in the June issue of the Journal of Consulting and Clinical Psychology, researchers found that psychological damage from childhood anxiety could be minimized or prevented when families participated in as few as eight weekly family sessions of cognitive behavioral therapy. Over the course of a year, family counseling sessions used cognitive-behavioral techniques to help parents modify behaviors that contributed to their children’s anxiety, including overprotection, excessive criticism and excessive expression of fear and anxiety in front of their children. Children were also taught coping and problem-solving skills.

“If psychiatrists or family doctors diagnose anxiety in adult patients, it’s now clearly a good idea that they ask about the patients’ children and, if appropriate, refer them for evaluation,” said the study’s senior investigator Golda Ginsburg, Ph.D., a child psychologist at Johns Hopkins Children’s Center and associate professor of psychiatry at the Johns Hopkins School of Medicine, in an internet press release on newswise. Ginsburg said the research indicates new treatment protocols for anxiety patients who are parents, noting that few doctors today consider the ramifications of parents’ mental illnesses on their children.

The Johns Hopkins study indicated that the children of parents who had been diagnosed with an anxiety disorder were seven times more likely to develop an anxiety disorder themselves. Sixty-five percent of children living with an anxious parent evidenced anxiety symptoms that met the criteria for an anxiety disorder. One in five U.S. children is affected by an anxiety disorder that often goes undiagnosed. In children, undiagnosed anxiety or delayed treatment can lead to depression, poor academic performance and substance abuse that can last throughout childhood and follow a child into adulthood. For these reasons, the Johns Hopkins team has been focusing on techniques to prevent, rather than treat, childhood anxiety. A larger study involving 100 families is now underway.

Two Cookies with Love

My supervisor in residency training gave me a saying that I thought was very descriptive.

When you’re a child, if you get two cookies with love, two cookies will always be enough. If you get two cookies without love, no amount of cookies will ever be enough (paraphrased).

Of course, the cookies are metaphorical for affirmation and nurturing. Our childhoods are formative years as this is the time we need validation the most. This period sets the stage for self-cohesion and a positive self-image. Inadequate nurturing and criticism leads to poor self-esteem and neediness.

It is important to note that our natural disposition (i.e. how we are hardwired) has some influence our self-esteem as some people need more affirmation than others. But even those with the most self-sufficient dispositions would have a hard time emerging from a heavily critical parent without some emotional dents to bang out as an adult.

So what do you do if you didn’t get your cookies with love? Rather than spending your life constantly chasing after more cookies, you have to find another source of validation. Some may find it by embracing their faith, for others it may be a long road of building confidence through progressively significant accomplishments. Some people can find healing through meeting the needs of others. Whatever works for you, the idea is that you lose the pattern of trying to feed an insatiable appetite for validation and progess to accepting a new positive image yourself that you help create.

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