The Mental Health Social Worker

NIMH-funded researchers recently completed a pilot study showing that an Internet-based, self-managed cognitive behavioral therapy (CBT) can help reduce symptoms of post-traumatic stress disorder (PTSD) and depression, with effects that last after treatment has ended. This study supports further development of PTSD therapies that focus on self-management and innovative methods of providing care to large numbers of people who do not have access to mental health care or who may be reluctant to seek care due to stigma. The researchers published their study in the November 2007 issue of the American Journal of Psychiatry. (more…)

NASW and NASW-NJ submitted amici curiae brief to support same sex couples

Edison, NJ – In a landmark decision, the New Jersey Supreme Judicial Court ruled that the state must amend its marriage statutes or create an equivalent legal structure for same-sex couples.  The National Association of Social Workers (NASW) and its New Jersey Chapter (NASW-NJ) laud the court’s holding that there is no legitimate governmental purpose to denying the financial and social benefits and privileges of marriage to same-sex couples while acknowledging that this falls short of recognizing a right to marry.

The New Jersey justices unanimously agreed in Lewis v. Harris, that “denying the rights and benefits to committed same-sex couples that are statutorily given to the heterosexual counterparts violates the equal protection guarantee” of the New Jersey State Constitution.   However, in a 4 – 3 ruling the court failed to recognize that these rights must be afforded the title of marriage and left that decision to the “political process.”  The court also recognized that same-sex couples may refer to their relationships by any term they choose and to have religious ceremonies honoring such commitments.  NASW and NASW-NJ filed an amici curiae brief in support of the plaintiffs. (more…)

Arlington, Va. – An eight-week program of self-management cognitive behavior therapy (CBT) delivered over the Internet to U.S. military service members produced greater reductions in posttraumatic stress disorder (PTSD) and depression than did Internet-based supportive counseling.

In a pilot study involving the Department of Veterans Affairs and Walter Reed Army Medical Center, 25 percent of patients randomly assigned to online self-management CBT no longer had a PTSD diagnosis after treatment or at six month follow-up, compared to 5 percent after treatment and 3 percent at six months for patients in the counseling comparison group. (more…)

Arlington, Va. – A child diagnosed with an anxiety or depressive disorder who also has a conduct or substance abuse disorder has a significantly higher risk of later being arrested for a major criminal offense as a teenager or young adult, according to researchers. The new findings, from Duke University’s Department of Psychiatry and Behavioral Sciences, appear in the November 2007 issue of The American Journal of Psychiatry (AJP), the official journal of the American Psychiatric Association (APA).

Different childhood histories, the researchers found, are associated with less serious charges against young adults. For example, childhood substance abuse, either alone or with an anxiety disorder, increases the risk of arrest for a minor offense, such as shoplifting. The odds of arrest for a moderately severe offense, such as simple assault or property-related crime, are increased by an anxiety disorder in girls but not boys. Furthermore, the combination of emotional and behavioral disorders remains an important risk factor even if the two disorders do not occur at the same time.

These new findings are part of the Great Smoky Mountains Study, which assessed children in 11 predominantly rural counties of North Carolina over several years. The analysis appears in the AJP study, “Childhood Psychiatric Disorders and Young Adult Crime: A Prospective, Population-Based Study” by William E. Copeland, Ph.D., and his colleagues Duke.

The group studied included 1,420 children, who were nine, 11, or 13 years old at the beginning of the study. Psychiatric disorders were assessed annually until age 16. According to official criminal charges, 473 of the youths were arrested between the ages of 16 and 21. Although a smaller percentage of females were arrested, the authors estimated that a larger proportion of their arrests was attributable to childhood psychiatric disorders: 21 percent versus 15 percent for males. These amounts are substantial; in comparison, the authors point out that the amount of risk for heart attacks that is attributable to being overweight is only 11 percent.

AJP editor-in-chief Robert Freedman, M.D., stated, “The first expressions of mental illness in childhood are becoming increasingly associated with problems later in life, including increased criminal behavior in some cases. The data in Dr. Copeland’s paper underscore the need for society to support early assessment and treatment of these vulnerable children.”

Childhood conduct disorder and substance abuse have previously been identified as risk factors for adult crime. The findings from the current study increase the specificity of the identified risk factors, from individual disorders to patterns of disorders in boys and girls. For instance, the combination of both depressive and anxiety disorders in boys actually lowered the risk of moderately severe crimes in early adulthood.

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Clinicians are already attentive to the risk for criminal activity among youth with conduct disorder. These findings draw attention to the role of other psychiatric disorders in children and to the importance of the occurrence of multiple disorders, even if they do not occur simultaneously.

The analysis took into account poverty status, but the sample was not representative of the U.S. population. Native Americans made up a substantial proportion but did not differ significantly from whites in their arrest rates. The sample contained few African Americans and no Latinos or Asian Americans. Although the participants lived in rural areas, the authors present evidence that crime

trends and crime-related factors are similar to those in urban areas.

“It is not necessarily surprising that a substantial proportion of criminals have a childhood history of psychiatric disorders and that conduct and substance disorders commonly precede criminality, but this study underscores the role of depressive and anxiety disorders-disorders not typically associated with criminal behavior-in even the most severe criminal offenses,” said lead author William Copeland, Ph.D.

This study was funded by the National Institute of Mental Health, the National Institute on Drug Abuse, and the William T. Grant Foundation.

Note to Editors: Contact Jim Rosack at 703-907-7862 / jrosack@psych.org or the APA Office of Communications and Public Affairs at 703-907-8640 / press@psych.org for an embargoed copy of the article and accompanying editorial.

About the American Journal of Psychiatry:

The American Journal of Psychiatry, the official journal of the American Psychiatric Association, publishes a monthly issue with scientific articles submitted by psychiatrists and other scientists worldwide. The peer review and editing process is conducted independently of any other American Psychiatric Association components. Therefore, statements in this press release or the articles in the Journal are not official policy statements of the American Psychiatric Association. The Journal’s editorial policies conform to the Uniform Requirements of the International Committee of Medical Journal Editors, of which it is a member. For further information about the Journal visit www.ajp.psychiatryonline.org.

About the American Psychiatric Association:

The American Psychiatric Association is a national medical specialty society whose more than 38,000 physician members specialize in diagnosis, treatment, prevention and research of mental illnesses including substance use disorders. Visit the APA at www.psych.org and www.HealthyMinds.org.

Arlington, Va. – As devastating wildfires continue to endanger and destroy California communities, the American Psychiatric Association (APA) expresses its deepest sympathies to all those affected by these devastating events and offers tips and resources on how to minimize the effects of trauma caused by destruction and loss of life during natural disasters. This type of natural disaster can have tremendous psychological impact on all those directly and indirectly affected. It is normal during natural disasters to experience a wide range of mental or emotional reactions, from sadness, stress and anxiety to more severe mental illness such as post traumatic stress disorder, ongoing anxiety disorders or depression. “Our immediate concerns are for the safety and well being of the community, the firefighters, the volunteers and the medical teams who are on the front lines helping with this tragedy,” said Arshad Husain, M.D., chair of the APA Committee on the Psychiatric Dimensions of Disasters. “The devastating effects from natural disasters impact the community at large. As psychiatrists we understand this disaster can cause significant distress and pose potential threats to the mental health of all those involved in the evacuation efforts, medical treatment and fighting the fires. It is important for everyone to know that help is available and treatment does work.”

After a traumatic event has passed, the APA recommends following these steps:

1. Keep informed about new information and developments, but avoid overexposure to news rebroadcasts of the event. Be sure to use credible information sources to avoid speculation and rumors.
2. If you feel anxious, angry or sad, you are not alone. Talk to friends, family or peers who likely are experiencing the same feelings.
3. If you have contact with children, keep open dialogues with them regarding their fears of danger. Let them know that, with time, healing from a tragedy is possible, even hoped for. Talk about your ability to cope with tragedy and get through the ordeal.
4. Feelings of anxiety and sadness following a traumatic event are natural. If these symptoms continue, even after order has been restored, or if these feelings begin to overwhelm you, seek the advice of a psychiatric physician in your local community. 

The APA provides online disaster psychiatry resources that may become useful as the impact of the fires continues. Please visit our web site at
http://www.psych.org/disasterpsych/links/weblinks.cfm. For more information on coping with mental illnesses, visit the APA’s consumer Web site: www.HealthyMinds.org.

About the American Psychiatric Association:
The American Psychiatric Association is a national medical specialty society whose more than 38,000 physician members specialize in diagnosis, treatment, prevention and research of mental illnesses including substance use disorders. Visit the APA at www.psych.org and www.HealthyMinds.org.

New Poll Shows Stress on the Rise, Affecting Health, Relationships and Work Americans Say Housing Costs an Added Stressor in 2007

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New York—One-third of Americans are living with extreme stress and nearly half of Americans (48 percent) believe that their stress has increased over the past five years. Stress is taking a toll on people — contributing to health problems, poor relationships and lost productivity at work, according to a new national survey released today by the American Psychological Association (APA).

Money and work continue as the leading causes of stress for three quarters of Americans, a dramatic increase over the 59 percent reporting the same sources of stress in 2006. The survey also found that the housing crisis is having an effect on many, with half of Americans (51 percent) citing rent or mortgage costs as sources of stress this year.

Nearly half of all Americans report that stress has a negative impact on both their personal and professional lives. About one-third (31 percent) of employed adults have difficulty managing work and family responsibilities and 35 percent cite jobs interfering with their family or personal time as a significant source of stress. Stress causes more than half of Americans (54 percent) to fight with people close to them. One in four people report that they have been alienated from a friend or family member because of stress, with 8 percent connecting stress to divorce or separation.

“Stress in America continues to escalate and is affecting every aspect of people’s lives — from work to personal relationships to sleep patterns and eating habits, as well as their health,” says psychologist Russ Newman, PhD, JD, APA executive director for professional practice. “We know that stress is a fact of life and some stress can have a positive impact, however, the high stress levels that many Americans report experiencing can have long-term health consequences, ranging from fatigue to obesity and heart disease.”

Stress Affecting Health

Twenty-eight percent of Americans say they are managing their stress extremely well. However, many people report experiencing physical symptoms (77 percent) and psychological symptoms (73 percent) related to stress in the last month. Physical symptoms of stress include: fatigue (51 percent); headache (44 percent); upset stomach (34 percent); muscle tension (30 percent); change in appetite (23 percent), teeth grinding (17 percent); change in sex drive (15 percent); and feeling dizzy (13 percent). Psychological symptoms of stress include: experiencing irritability or anger (50 percent); feeling nervous (45 percent); lack of energy (45 percent); and feeling as though you could cry (35 percent). In addition, almost half (48 percent) of Americans report lying awake at night due to stress.

How Americans Manage Stress

While Americans deal with high levels of stress on a daily basis, the health consequences are most serious when that stress is managed poorly. Four in ten Americans (43 percent) say they overeat or eat unhealthy foods to manage stress, while one-third (36 percent) skipped a meal in the last month because of stress. Those who drink (39 percent) or smoke cigarettes (19 percent) were also more likely to engage in these unhealthy behaviors during periods of high stress. Significant numbers of Americans report watching TV for more than two hours a day (43 percent) and playing video games or surfing the Internet (39 percent). Healthy behaviors used to manage stress included: listening to music (54 percent); reading (52 percent); exercising or walking (50 percent); spending time with family and friends (40 percent); and praying (34 percent).

Motivating Factors in Lifestyle and Behavior Change

While many Americans recognize that stress has a negative impact on their health, they may lack the motivation to make lifestyle and behavior changes. Only 35 percent report that they would modify their behavior following the diagnosis of a chronic condition. Primary motivators include: a desire to feel better (60 percent); desire to reduce amount of stress (45 percent); and desire to improve self-image or self-esteem (41 percent). Encouragement from a spouse or partner would motivate 38 percent to make behavioral changes.

The Stress in America survey is part of APA’s Mind/Body Health Public Education Campaign. For information on the survey or managing stress, visit www.apahelpcenter.org.

Methodology

In September 2007, the American Psychological Association commissioned its annual nationwide survey to examine the state of stress across the country. The research measured attitudes and perceptions of stress among the general public, identifying leading sources of stress, common behaviors used to manage stress and the impact of stress on our lives. The survey explored appropriate and excessive stress levels; circumstances, situations and life events that cause stress; activities, resources and behaviors people use to deal with stress; and the personal costs of stress.

This survey was conducted online within the United States by Harris Interactive between August 30 and September 11, 2007, among 1,848 adults (aged 18 and over). Interviews were conducted in English and Spanish. Figures for age, sex, race/ethnicity, education, region and household income were weighted where necessary to bring them in line with their actual proportions in the population. Hispanic respondents were also weighted based on language usage. Propensity score weighting was also used to adjust for respondents’ propensity to be online.

With a pure probability sample of 1,848 one could say with a 95 percent probability that the overall results would have a sampling error of +/- 2 percentage points. Sampling error for data based on sub-samples would be higher and would vary. However, that does not take other sources of error into account. This online survey is not based on a probability sample and therefore no theoretical sampling error can be calculated.

How much do you know about stress?

Stress tip sheet

Stress in America report (.doc)

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world’s largest association of psychologists. APA’s membership includes more than 148,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.

The National Institutes of Health will intensify its efforts to find the causes of autism and identify new treatments for the disorder, through a new research program.

The Autism Centers of Excellence (ACE) program represents a consolidation of two existing programs, the Studies to Advance Autism Research and Treatment (STAART) and Collaborative Programs of Excellence in Autism (CPEA) programs into a single research effort.

“The consolidation was needed to capitalize on the gains made by the NIH research effort in autism,” said Elias Zerhouni, M.D., Director of the National Institutes of Health. NIH autism program officials hope to expand on earlier discoveries made by research previously supported by the NIH.

The NIH Institutes providing funding and expertise for the effort are the National Institute of Child Health and Human Development, the National Institute of Deafness and other Communication Disorders, the National Institute of Environmental Health Sciences, the National Institute of Mental Health and the National Institute of Neurological Disorders and Stroke.

Autism is a complex brain disorder involving communication and social difficulties as well as repetitive behavior or narrow interests. Autism is often grouped with similar disorders, all of which may be referred to collectively as autism spectrum disorders (ASD). The underlying causes of ASD are unclear. Currently, there is no cure for the disorders and treatments are limited.

The ACE program will encompass research centers and research networks. The research centers will foster collaborations between teams of specialists, who share the same facility so that they can address a particular research problem in depth. For example, specialists in brain imaging might collaborate with behavior researchers to determine if a particular behavior is associated with a difference in brain structure. They might also consult with a team of genetics experts to find a hereditary basis for their observations.

ACE networks consist of researchers at many facilities in locations throughout the country, all of whom work together on a single research question. Because networks encompass multiple sites, they can recruit large numbers of participants with a particular disorder.

Initially, five centers and two networks received funding in 2007 to study ASD. Funding for a second set of ACE research programs will be announced in 2008.

All ACE award recipients will contribute their data to the National Database for Autism Research (NDAR). Housed at NIH, NDAR is a Web-based tool that autism researchers around the world can use to collect and share information on autism.

The 2007 ACE program Center award recipients are:

— Edwin H. Cook (University of Illinois at Chicago): Researchers at the University of Illinois at Chicago ACE Center will focus on understanding the repetitive behavior seen in ASD. Known as “insistence on sameness,” this behavior is a hallmark of ASD. Examples of insistence on sameness include wanting to wear the same clothes every day, taking the same route to work or school, or becoming fixated on certain subject matter, such as buildings or cars. Center researchers will focus on genetic factors as well as brain chemicals and brain functions that could account for repetitive behaviors in people with ASD, and test whether genetic differences influence how individuals respond to certain medications intended to reduce the occurrence of these behaviors.

— Eric Courchesne (University of California, San Diego): Researchers at the UCSD ACE Center also will use brain imaging to track brain development in children believed to be at risk for autism spectrum disorders. Unlike other ACE program projects, which will attempt to identify forerunners of ASD in the siblings of children with ASD, the UCSD researchers will study infants who have been referred by their physicians. The physicians will make the referrals on the basis of a checklist of behaviors that are similar to those of older children with ASD. The primary goal of this center is to identify brain or other physical differences that might predispose a child to autism. The UCSD Center will collect some of the first information ever obtained on how the brains of very young children with autism process and respond to information.

— Geraldine Dawson (University of Washington). Researchers at the University of Washington ACE Center will seek to identify genes and other potential factors that may predispose an individual toward ASD, as well as factors that might protect against them. In addition to genes, the researchers will try to determine the risk of ASD by examining communication difficulties, early behaviors, patterns in the sounds babies make, and brain structure and activity patterns. Researchers will also try to determine whether certain types of interactions between the parent and baby can decrease the chances for ASD.

— Nancy J. Minshew (University of Pittsburgh): Researchers at the University of Pittsburgh ACE Center will study how people with ASD learn and understand information. Research shows that the ability to organize information into categories is critical to language development. The Pittsburgh researchers will use brain imaging techniques to study how infants at risk for autism and toddlers diagnosed with the disorder place information into categories. Researchers will also use brain imaging techniques to study which parts of the brain are activated in people with and without ASD when processing information and emotions.

— Marian D. Sigman (University of California, Los Angeles): Researchers at the UCLA ACE Center will seek to understand how ASD affects the ability to communicate. The researchers will try to find clues to language-related communications problems by looking at genes, behavior and brain structure and functioning. The researchers also are interested in disorders that affect the mirror neurons. Mirror neurons are brain cells that become active either when a person performs an action or watches the action performed by someone else. When many patients with ASD are asked to imitate behaviors, images of their brains show that their mirror neurons are less active than those of other people. The researchers will try to stimulate the mirror neurons of people with ASD by having them follow a set of instructions to complete a task.

The 2007 ACE program Network award recipients are:

— Joseph Piven (University of North Carolina at Chapel Hill): In hopes of identifying brain differences in children who develop ASD, researchers at this Network of sites operating under the direction of the University of North Carolina will use brain imaging techniques to compile images of the brains of very young infants. Some of these children may go on to develop ASD. Their brain images will be compared to those of other infants, to identify differences between children who develop autism and those who do not. While previous studies have documented the enlarged brains often seen in ASD patients, little is known about the abnormal processes during early brain development in children with ASD. The research could offer new insights that lead to earlier diagnosis of ASD.

— Sally Rogers (University of California, Davis): To address the need for controlled studies of treatments for autism in very young children, researchers at this Network of sites operating under the direction of UC Davis will compare an intensive behavioral intervention to standard community-based treatment in 18-24-month-old children with autism. This work builds on previous research by Rogers and colleagues, which, in early studies, suggests that the intensive early treatment provides better outcomes than standard community-based treatment. This new research will examine factors that can inform efforts to provide the best treatment outcomes for very young children with autism.

Family Intervention that Improves Behavior, Social Skills Also Improves Cortisol Patterns

A family-based behavioral intervention that helps prevent social and behavior problems in high-risk preschoolers also may help normalize their cortisol levels when they anticipate stressful situations, results of a new NIMH study suggest.  Cortisol is a hormone that regulates response to stress.  Imbalances in stress regulation are thought to contribute to the development of some mental disorders, such as anxiety disorders and depression.

Results of the study were published in the October issue of Archives of General Psychiatry by NIMH investigators Laurie Miller Brotman, PhD, and Daniel S. Pine, MD, and colleagues.

Studies show that children who are developing normally and are at low risk of developing antisocial behavior and conduct problems have a boost in cortisol when facing stress.  However, some studies have shown that the boost in cortisol does not occur in children at high risk of developing these problems.

The preschoolers in this study were told they would be playing with an unfamiliar group of children later, a stressful situation for this age group.  Children were identified as high risk for psychopathology if they had been exposed to a combination of several risk factors; for example, parenting practices that promote behavior problems, siblings in trouble with the law, mothers with mental disorders, and poverty.

About half of the 92 high-risk children and their families were offered almost six months of a weekly intervention shown by previous research to improve parenting practices and children’s social skills.  The other half of the group did not receive the intervention.

When anticipating the play session, high-risk children who had gone through the intervention had cortisol boosts similar to those in low-risk children.  But children who had not gone through the intervention lacked this normal increase in cortisol.

“This anticipatory increase in cortisol may have developed in us as a signal that stress is warranted – that something in our environment is important and we need to pay attention to it,” Pine said.  “Children who don’t show this pattern may be less biologically equipped to adapt to stressful situations. That a family-based intervention was found to alter this important neurobiological system provides a window on the dynamic interaction of environment, behavior, and brain to shape the course of adaptive development in children.”

Reference:

Brotman LM, Gouley KK, Chesir-Teran D, Kamboukos D, Huang KY, Fratto C, Pine DS.  Effects of a psychosocial family-based preventive intervention on cortisol response to a social challenge in preschoolers at high risk for psychopathology.  Archives of General Psychiatry, October 2007.

Press Contact(s)

Susan Cahill
NIMH Press Office
301-443-4536
nimhpress@nih.gov

More NIMH Science News about:

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• NIMH Mental Health Information
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• CRISP: NIH research database of current and completed research
• PubMed Central: An archive of life sciences journals
• News from the Field: Research findings of NIMH-funded investigators, from EurekAlert

Recent breakthroughs in phone counseling services have jump-started a new market that is safe, private, and professional. Counselors and therapists are now available by phone or chat to take calls 24/7 from anywhere in the US, and consumers can view and leave ratings for the practitioners as well.

In years past, popular pay-per-usage telephone services were phone psychics, and phone chat lines. The rates were high, and the services were poor. Needless to say, their popularity soon faded along with the rubix cube and magic 8-ball.

Lately, a new professional service has emerged over the telephone with a similar pay-per-usage model, only this one seems like it may stick. Online phone counseling has become available over the internet and is becoming widely accepted. On some websites, like Phone-Counseling.org, the visitor can choose from a list of therapists who are available for chat or phone counseling. The list can have 20 or more therapists, along with pictures and a short statement from the counselor. Next to the therapist listing, there will be an “Online” statement that indicates whether or not that therapist is currently available.

The systems that make this type of live, on-demand service possible are provided by a company called Kasamba. Kasamba does more than just phone counseling though; consulting in many different forms is available through their network of “experts.” Kasamba’s experts have a program installed that can indicate their online status and be used for chat. Their servers house the system that takes care of billing and all of the back-end operations. It is a very unique and robust application. When a consumer decides to contact a live therapist, all they have to do is click the “contact live” button and fill in some basic information to create an account. From there, they will be assigned a phone number to call that will connect them with the therapist of their choice.

Phone counselors can be from many different educational backgrounds, but all should be licensed by the state in which they practice. Some typical credentials one may see behind a therapist’s name are: LCSW, Ph.D., MA, LPC, LMFT and LMHC. In that order, the credentials stand for “Licensed Clinical Social Worker,” “Doctor of Philosophy” (Psychologist), “Master of Arts (in counseling),” “Licensed Practicing Counselor,” “Licensed Marriage and Family Therapist,” and “Licensed Mental Health counselor.” All of these educational backgrounds can vary in their degree of training on different expertise. Specialties even exist amongst each individual from the same educational background. That’s why it can be very helpful to inquire about a therapist’s training in the area you need help with. Ideally, if a therapist doesn’t have the necessary experience to work effectively with the issues you are facing, they will refer you to someone who does.

Phone counseling presents a new and more accessible way for therapists to connect with patients. Kasamba’s network has been successful in their implementation of this service, so who knows where it may one day lead? There may come a day when we can do physician referrals over the internet and telephone rather than waiting in a crowded doctor’s office. Phone counseling has many uses, for people who don’t have access to transportation or therapists within their area – to people suffering from severe anxiety or depression who need someone to speak to right away. Visit http://phone-counseling.org, for more information.

MINNEAPOLIS–(BUSINESS WIRE)–Individuals trying to cope with the emotional consequences of the Southern California wildfires now have access to a free Help Line staffed by experienced master’s-level specialists. These specialists can assist callers with a broad range of personal concerns.

The toll-free Help Line number is (866) 342-6892. It will be open 24 hours a day, seven days a week for as long as necessary. Service is free of charge.

Normally, these services are routinely available to UnitedHealth Group customers through its operating unit OptumHealth Behavioral Solutions. However, the Help Line is now being made available to address the potential needs among the general population in Southern California.

Previously, the Help Line was made available to the public following hurricanes, including those that have hit Florida and the Gulf Coast over the past two years, and to individuals affected by the tragic shootings on the Virginia Tech campus in Blacksburg, Va., and the recent Minnesota Interstate 35W bridge collapse. Several thousand people have taken advantage of this service in the past to speak to specialists about the difficult emotions they may experience related to stress, anxiety and the grieving process. Callers also may receive referrals from a national database of community resources to help them with specific concerns, such as financial and legal issues. Resources and information are also available via the Internet at www.liveandworkwell.com.

About UnitedHealth Group

UnitedHealth Group (www.unitedhealthgroup.com) is a diversified health and well-being company dedicated to making health care work better. Headquartered in Minneapolis, Minn., UnitedHealth Group offers a broad spectrum of products and services through six operating businesses: UnitedHealthcare, Ovations, AmeriChoice, Uniprise, OptumHealth and Ingenix. Through its family of businesses, UnitedHealth Group serves approximately 70 million individuals nationwide.

About OptumHealth

As one of the nation’s largest health and well-being companies, OptumHealth makes health care easier and better for employers, health plans, public sector entities and the 58 million people with access to its services. The Company’s goal is to optimize health, well-being and financial security, while lowering benefit costs and helping consumers make informed decisions about their health through standalone or integrated services. OptumHealth is a division of UnitedHealth Group (NYSE:UNH). More information about OptumHealth can be found at www.OptumHealth.com.

Psychotherapy Combined with Antidepressant Medication Most Effective

A combination of psychotherapy and antidepressant medication appears to be the most effective treatment for adolescents with major depressive disorder—more than medication alone or psychotherapy alone, according to results from a major clinical trial funded by the National Institutes of Health’s National Institute of Mental Health (NIMH). The study was published in the October 2007 issue of the Archives of General Psychiatry.

The long-term results of the Treatment for Adolescents with Depression Study (TADS) found that when adolescents received fluoxetine (Prozac) alone or in combination with cognitive behavioral therapy (CBT) over the course of 36 weeks, they recovered faster than those who were receiving CBT alone.   (more…)

How genes and the environment shape the brain circuitry underlying social behavior is among the questions being addressed by three newly NIMH-funded studies. The basic science grants, totaling more than $6 million over 4-5 years, are aimed at understanding how the brain processes social behaviors — processes which are disrupted in autism, schizophrenia, anxiety disorders and other mental illnesses.

“By building bridges between fields that usually don’t talk much to each other, we’re hoping to translate progress in this rapidly growing area into help for people with mental illnesses,” said Kevin Quinn, Ph.D., chief of NIMH’s Behavioral Science and Integrative Neuroscience Research Branch, Division of Neuroscience and Basic Behavioral Science.

The three grants combine neurobiological approaches with studies of social behaviors in both animals and humans.

• Pat Levitt, Ph.D., and colleagues, Vanderbilt University, will probe the mechanisms of gene-environment interactions in social development, focusing on five brain genes implicated in autism, including genes that code for oxytocin and the MET receptor tyrosine kinase. In mice and human infants, they will determine the relationship between early social learning and later sociability.
• Edward Brodkin, M.D., and colleagues, University of Pennsylvania, will follow-up on the clue that people with autism tend to have abnormally enlarged brains in childhood and an underdeveloped corpus callosum. Working with inbred mouse strains, they will explore whether similar anatomical features go along with reduced sociability — and the interplay of genetic and environmental influences on these traits.
• Paul Whalen, Ph.D., and colleagues, Dartmouth College, will use functional neuroimaging in humans to build on studies showing how fearful facial expressions trigger the amygdala and related brain anxiety-processing circuitry. They will explore these questions using human social stimuli as conditioning cues.

The grants were awarded to investigators responding to a request for proposals inspired by a 2005 workshop convened to help identify research opportunities in the social neuroscience of mental health.