The Mental Health Social Worker

WASHINGTON—Living in another country can be a cherished experience, but new research suggests it might also help expand minds. This research, published by the American Psychological Association, is the first of its kind to look at the link between living abroad and creativity.

“Gaining experience in foreign cultures has long been a classic prescription for artists interested in stimulating their imaginations or honing their crafts. But does living abroad actually make people more creative?” asks the study’s lead author, William Maddux, PhD, an assistant professor of organizational behavior at INSEAD, a business school with campuses in France and Singapore. “It’s a longstanding question that we feel we’ve been able to begin answering through this research.”

Maddux and Adam Galinsky, PhD, from the Kellogg School of Management at Northwestern University, conducted five studies to test the idea that living abroad and creativity are linked. The findings appear in the May issue of the Journal of Personality and Social Psychology, published by the American Psychological Association.

In one study, master of business administration students at the Kellogg School were asked to solve the Duncker candle problem, a classic test of creative insight. In this problem, individuals are presented with three objects on a table placed next to a cardboard wall: a candle, a pack of matches and a box of tacks. The task is to attach the candle to the wall so that the candle burns properly and does not drip wax on the table or the floor. The correct solution involves using the box of tacks as a candleholder – one should empty the box of tacks and then tack it to the wall placing the candle inside.

The solution is considered a measure of creative insight because it involves the ability to see objects as performing different functions from what is typical (i.e., the box is not just for the tacks but can also be used as a stand). The results showed that the longer students had spent living abroad, the more likely they were to come up with the creative solution.

In another study, also involving Kellogg School MBA students, the researchers used a mock negotiation test involving the sale of a gas station. In this negotiation, a deal based solely on sale price was impossible because the minimum price the seller was willing to accept was higher than the buyer’s maximum. However, because the two parties’ underlying interests were compatible, a deal could be reached only through a creative agreement that satisfied both parties’ interests.

Here again, negotiators with experience living abroad were more likely to reach a deal that demanded creative insight. In both studies, time spent traveling abroad did not matter; only living abroad was related to creativity.

Maddux and Galinsky then ran a follow-up study to see why living abroad was related to creativity. With a group of MBA students at INSEAD in France, they found that the more students had adapted themselves to the foreign cultures when they lived abroad, the more likely they were to solve the Duncker candle task.

“This shows us that there is some sort of psychological transformation that needs to occur when people are living in a foreign country in order to enhance creativity. This may happen when people work to adapt themselves to a new culture,” said Galinsky.

Although these studies show a strong relationship between living abroad and creativity, they do not prove that living abroad and adapting to a new culture actually cause people to be more creative. “We just couldn’t randomly assign people to live abroad while others stay in their own country,” said Maddux.

To help get at this question of what causes someone to be creative, the authors tried a technique called “priming.” In two experiments, they asked groups of undergraduate students at the Sorbonne in Paris to recall and write about a time they had lived abroad or adapted to a new culture; other groups were asked to write about other experiences, such as going to the supermarket, learning a new sport or simply observing but not adapting to a new culture.

The results showed that priming students to mentally recreate their past experiences living abroad or adapting to a new culture caused students, at least temporarily, to be more creative. For example, these students drew space aliens and solved word games more creatively than students primed to recall other experiences.

“This research may have something to say about the increasing impact of globalization on the world, a fact that has been hammered home by the recent financial crisis,” said Maddux. “Knowing that experiences abroad are critical for creative output makes study abroad programs and job assignments in other countries that much more important, especially for people and companies that put a premium on creativity and innovation to stay competitive.”

Article: “Cultural Borders and Mental Barriers: The Relationship Between Living Abroad and Creativity,” William W. Maddux, PhD, INSEAD; Adam D. Galinsky, PhD, Kellogg School of Management at Northwestern University; Journal of Personality and Social Psychology, Vol. 96, No. 5.

(Full text of the article is available from the APA Public Affairs Office and at http://www.apa.org/journals/releases/psp9651047.pdf)

Contact William Maddux via e-mail; his phone number is (+33) 680-30-7369.

Contact Adam Galinsky via e-mail; his phone number is 773-495-2999.

The American Psychological Association, in Washington, D.C., 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 150,000 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.

Mental Health America’s “Live Your Life Well^SM“

Offers 10 Proven Tools to Combat Stress and Promote Well-Being

Contact: Steve Vetzner, (703) 797-2588 or svetzner@mentalhealthamerica.net

ALEXANDRIA, Va. (April 27, 2009) — From financial worries to family responsibilities, Americans are dealing with ever-increasing stress in their lives. To help handle these challenges, Mental Health America today launched an innovative public education campaign to provide people with tools to deal with stressful times. Called Live Your Life Well^SM, it features a wealth of research-based information, coupled with strategies that can help combat stress and promote well-being.

“The economic crisis has added to the daily stress that all American families face, and may be increasing their risk of depression and anxiety as well,” said David Shern, Ph.D., president of Mental Health America. “Live Your Life Well^SM is the first program in the U.S. that brings together the information needed to help all Americans in difficult times and throughout their lives. Good mental health is much more than just the absence of illness – it’s about being able to handle life’s challenges and even flourish.”

The heart of the program is the Live Your Life Well^SM Web site (http://www.liveyourlifewell.org/iveYourLifeWell.org), which provides 10 evidence-based tools to bolster mental health. “Research is clear that good mental health is essential for overall health and well-being,” said Sonja Lyubomirsky, Ph.D., noted author of The How of Happiness: A Scientific Approach for Getting the Life You Want and a psychologist at University of California Riverside. “There are actions that people can take that can improve their mental health and increase their well-being, and even modest changes can make a real difference.”

Live Your Life Well^SM is unlike any other public education campaign. It offers scientific evidence for a range of concrete actions that promote mental wellness. The contents are derived from decades of behavioral and medical research with thousands of individuals, often conducted at major universities or funded by government agencies. Written in consumer-friendly language, the program offers dozens of easy-to-follow suggestions from behavioral health experts and tips on sustaining the advice.

The Live Your Life Well^SM program details the 10 tools and many of their benefits, including:

• Connect with Others. Research suggests that people who feel connected are happier and healthier – and may even live longer.
• Stay Positive. People who regularly focus on the positive in their lives are less upset by painful memories.
• Get Physically Active. Exercise relieves tense muscles, improves mood and sleep, and increases energy and strength.
• Help Others. Research suggests that those who consistently help other people experience less depression, greater calm and fewer pains.
• Get Enough Rest. People who don’t get enough sleep face a number of possible health risks, including weight gain, decreased memory, impaired driving and heart problems.
• Create Joy and Satisfaction. Positive emotions can boost a person’s ability to bounce back from stress.
• Eat Well. Eating healthy food and regular meals can increase energy, lower the risk of developing certain diseases and influence mood.
• Take Care of Your Spirit. People who have strong spiritual lives may be healthier and live longer. Spirituality seems to cut the stress that can contribute to disease.
• Deal Better with Hard Times. People who get support, problem-solve or focus on the positives in their lives are likely to handle tough times better.
• Get Professional Help if You Need It. If the problems in life are stopping a person from functioning well or feeling good, professional help can make a big difference.

“Just as Americans have learned there are things they can do to reduce their risk of heart disease and other illnesses, Mental Health America wants to help people learn what they can do both to protect their mental health in tough times and also to improve their mental well-being throughout their lives,” explained Shern.

The campaign is being launched for Mental Health Month in May. More details on each of the tools are available on the campaign Web site, which is free to the public at www.LiveYourLifeWell.org.  More information and help locating mental health resources, including mental health professionals, is available through Mental Health America and its affiliates across the country by contacting their Resource Center at  http://www.mentalhealthamerica.net/.

Children with attention deficit hyperactivity disorder (ADHD) who take medication to treat the condition tend to do better in math and reading compared to their peers who also have ADHD but do not take medication, according to data from a national survey. The NIMH-funded study was published in the May 2009 issue of Pediatrics.

Background

ADHD, which is characterized by poor concentration, distractibility, hyperactivity, impulsivity and other symptoms, can adversely affect a child’s academic performance. Compared to their peers without the disorder, children with ADHD tend to have lower grades, lower math and reading scores, and are more likely to repeat a year or drop out of school.

Richard Scheffler, Ph.D., of the University of California Berkeley, and colleagues analyzed a sample of 594 children diagnosed with ADHD who were part of the nationally representative Early Childhood Longitudinal Study—Kindergarten Class of 1998-1999, a U.S. Department of Education survey. The children were surveyed for various issues five times between kindergarten and fifth grade. The researchers focused on the children’s math and reading scores to determine if medication use for ADHD was associated with academic achievement during elementary school.

Results of the Study

The study found that students with ADHD who took medication had math scores that were on average 2.9 points higher and reading scores on average 5.4 points higher than their unmedicated peers with ADHD. This equated to gains that were equivalent to the progress typically made in one-fifth of a school year in math, and one-third of a school year in reading. Improvements in reading, however, were seen only in students who had been taking medication for at least two rounds of the survey. The authors suggest that the different findings between math and reading scores may point to underlying differences in the process of learning.

Significance

The findings echo previous studies that have found that use of ADHD medication can improve children’s attention and memory skills, which can help them do better in school. In addition, the improvement is notable because early academic success often predicts later school progress, said the researchers. However, they caution that the gains are not enough to eliminate the achievement gap typically seen between children with ADHD and those without the disorder.

What’s Next

The findings support the need for long-term studies designed to better understand the relationship between medication use and academic achievement in children with ADHD. The authors also conclude by noting that more research is needed on combining medication with behavioral interventions to improve the school performance of children with ADHD.

Reference

Scheffler RM, Brown TT, Fulton BD, Hinshaw SP, Levine P, Stone S. Positive association between attention deficit/hyperactivity disorder medication use and academic achievement during elementary school. Pediatrics. 2009 May. 123(5): 1273-1279.

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Atypical antipsychotic medications are associated with weight gain and other metabolic changes among patients with Alzheimer’s disease, according to a recent analysis of data from the NIMH-funded Clinical Antipsychotic Trials of Intervention Effectiveness—Alzheimer’s Disease (CATIE-AD) study. The study was published online ahead of print April 15, 2009, in the American Journal of Psychiatry.

Background

Most of the data on the metabolic effects of atypical antipsychotics—also called newer or second generation antipsychotics—is from younger or middle-aged adults with schizophrenia. The metabolic effects on patients with Alzheimer’s disease taking these medications have not been systematically assessed until now.

The CATIE-AD study compared the atypical antipsychotics olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal) to a placebo (inactive pill) among 421 participants with Alzheimer’s disease. Previously reported results from the CATIE-AD study found that the medications can benefit some patients in treating hallucinations, delusions, aggression and other similar symptoms, but they appear to be no more effective than a placebo when adverse side effects are taken into account. This most recent analysis, conducted by Ling Zheng, M.B.B.S., Ph.D. and Lon S. Schneider, M.D., of the University of Southern California, and colleagues, examined metabolic side effects associated with the medications.

Results of the study

During the first 12 weeks of the trial, olanzapine and quetiapine were significantly associated with weight gain—up to 0.14 pounds per week. Women gained more weight than men, and weight gain increased the longer a patient stayed on the medication. In addition, olanzapine was associated with a decrease in HDL (good) cholesterol and increased waist size. The researchers theorized that women gained more weight than men because older women tend to have more body fat and less lean body mass than older men, potentially making them more susceptible to the medications’ metabolic side effects.

Significance

Previous results from CATIE-AD found only modest effectiveness in treating behavioral symptoms of Alzheimer’s disease while adverse effects limited improvements overall. The results of this latest analysis suggest further caution is needed when using atypical antipsychotics to treat Alzheimer’s patients. The researchers conclude that Alzheimer’s patients receiving atypical antipsychotics should be monitored very closely.

What’s next

Further studies are needed to better determine which Alzheimer’s patients may benefit from use of atypical antipsychotics, and which may be more susceptible to serious side effects.

Reference

Zheng L, Mack WJ, Dagerman KS, Hsaio JK, Lebowitz BD, Lyketsos CG, Stroup TS, Tariot PN, Vigen C. Schneider L. Metabolic changes associated with second-generation antipsychotic use in Alzheimer’s disease patients: the CATIE-AD study. American Journal of Psychiatry. Online ahead of print April 15, 2009.

In our increasingly urbanized world, it turns out that a little green can go a long way toward improving our health, not just that of the planet.

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Chronic stress from growing up poor appears to have a direct impact on the brain, impairing working memory, researchers at Cornell University in New York report that The 14-year study of 195 children from households both above and below the poverty line found that chronic stress played a major role in their cognitive development. The study suggests that greater proportion a child in a family spent in poverty, the poorer their working memory, and that link is largely explained by this chronic physiologic stress.  The findings have implications for education where stress at home may have to be included as a factor in teachers’ efforts to help underachieving children. (The Washington Post, 4/6/09)

Black American teens, especially females, may be at high risk for attempting suicide even if they have never been diagnosed with a mental disorder, according to researchers funded in part by NIMH. Their findings, based on responses from adolescent participants in the National Survey of American Life (NSAL), provide the first national estimates of suicidal thoughts and behaviors (ideation) and suicide attempts in 13- to 17-year-old black youth in the United States. The study was published in the March 2009 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

Background

Suicide is the third leading cause of death in all teens in the United States, according to the National Center for Health Statistics. Historically, black teens and young adults have lower suicide rates than white teens, but in recent decades, the suicide rate for black youth has increased dramatically.

The NSAL is a nationally representative, household survey of African Americans and blacks of Caribbean descent. From the NSAL households, 810 African American and 360 Caribbean black teens, ages 13-17, were randomly selected to complete the NSAL-Adolescent (NSAL-A) survey.

Findings from this Study

Sean Joe, Ph.D., LMSW, University of Michigan, and colleagues evaluated NSAL-A teens’ responses to questions about suicidal ideation and nonfatal suicide attempts. According to the researchers, such attempts may occur up to 10-40 times more often than completed suicides and are important risk factors for future suicide.

According to the study, in a given year, African American teen girls are most likely to attempt suicide, followed by Caribbean teen girls, African American teen boys, and Caribbean teen boys.

However, Caribbean females in the study reported the highest rates for suicidal ideation, while Caribbean teen males reported the lowest rates for ideation and suicide attempts. This is in contrast to a previous NSAL report, which found that Caribbean adult males had the highest rates of suicide attempts among black Americans.

Also in contrast to previous studies, the researchers noted that youth from lower income households ($18,000-$31,999 annually) were least likely to report attempting suicide, while youth living in homes of modest means ($32,000-$54,999) were most likely.

Having a mental disorder was closely linked to attempted suicide among study participants. Teens with anxiety disorders were a highest risk. Despite this relationship, roughly half of teens who attempted suicide did not have or were never diagnosed with a mental disorder.

As in previous studies, teens living in the U.S. South and West appeared to be less at risk for attempted suicide than those living in the Northeast.

Overall, the researchers estimated that at some point before they reach 17 years of age, 4 percent of black teens, and more than 7 percent of black teen females, will attempt suicide.

Significance

Suicide prevention efforts require a better understanding of population-specific risk factors. This study provides the first national estimates for rates of suicidal ideation and attempts among black youth in the United States, including important information on ethnic differences.

What’s Next

According to the researchers, their findings show the need for further studies on risk factors for suicide in this population, especially on ethnicity-specific risks and non-psychiatric risks. Because only half of suicide attempters had ever been diagnosed with a psychiatric disorder, Joe and colleagues suggest that suicide prevention efforts should include screening for suicidal behaviors in clinical and non-clinical settings (schools, community centers, etc.) when working with black teens, especially females.

Reference

Joe S, Baser RS, Neighbors HW, Caldwell CH, S Jackson J. 12-Month and Lifetime Prevalence of Suicide Attempts Among Black Adolescents in the National Survey of American Life. J Am Acad Child Adolesc Psychiatry. 2009 Mar;48(3):271-82.PMID: 19182692.

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APA PRESS RELEASE

COMMUNITY PROGRAM SUCCESSFUL IN PREVENTING CHILD ABUSE – MARKS CHILD ABUSE PREVENTION MONTH

Five Questions for Gary Melton, PhD

Gary Melton, PhD
Gary Melton — a psychologist and a professor and director of the Institute on Family and Neighborhood Life at Clemson University (http://www.clemson.edu/ifnl) — focuses on the links among public policy, community supports and the well-being of children and families. As vice chair of the U.S. Advisory Board on Child Abuse and Neglect in the early 1990s, he led the board’s development of a neighborhood-based strategy for child protection. Dr. Melton has led the test of that strategy in Strong Communities for Children, a foundation-funded, community-wide initiative (more than $10 million over 7.5 years) to prevent child abuse and neglect in parts of Greenville and Anderson counties in South Carolina (http://www.clemson.edu/strongcommunities).

To mark Child Abuse Prevention Month, APA spoke with Dr. Melton about the success of his community program and why it is working so well.

APA: What’s wrong with the current approach to protecting children in the United States?

Dr. Melton: The current approach to child protection was adopted in every state in the early 1960s and is now outdated. The hallmark of the approach is mandated reporting and investigation of cases of suspected child abuse and neglect — in essence, case-finding. This strategy was the product of an extraordinarily influential article in the Journal of the American Medical Association. At the time, however, the authors estimated that there were about 300 cases of child maltreatment in the United States each year, but today, we have about 3 million calls each year to Child Protective Services to report suspected child abuse or neglect. Case-finding isn’t the problem!

The designers of the child protection system also typically assumed that there was something very wrong with parents who maltreated their children — that they were very sick or simply very evil. In the majority of cases (both reported and unreported), however, child maltreatment involves neglect, not abuse, and the neglect is not willful. Instead, neglecting parents are typically overwhelmed by a multitude of problems without having the means — both economic and social — to solve them. Their supervision of their children becomes less diligent because they are trying to cope alone with too many social and economic problems.

Unfortunately, the question that the child protection system is designed to answer is, “What happened?” not, “What can we do to help?” And it definitely is not designed to answer the latter question before abuse or neglect occurs.

As the U.S. Advisory Board on Child Abuse and Neglect concluded, “it has become far easier to pick up the telephone to report one’s neighbor for child abuse than it is for that neighbor to pick up the telephone to request and receive help before the abuse happens.” Instead, we spend vast resources on law-enforcement-style investigations by child protection workers — investigations that usually do not result in meaningful services. (more…)