Mapping future of adolescent substance use treatment

 

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Adolescent substance use treatment is at a critical turning point -- treatment success is short-lived and the field lacks a definitive best approach. Researchers from the University of Pittsburgh conducted a comprehensive literature review to identify the common traits underlying different therapies aimed at reducing substance use and then recommend future directions. Their findings are available as part of an adolescent-focused special issue from Substance Abuse, the official journal of Association for Medical Education and Research in Substance Abuse (AMERSA) and a publication from Routledge.

"Psychotherapy research has shifted," co-author Dr. Tammy Chung mentioned, "from comparing outcomes across different types of treatment to determining 'how' and 'for whom' an intervention works." In keeping with this new approach, the review at hand focused on studies concerning mechanisms of change for various "brands" of psychotherapy and distilled important implications for treating adolescent substance users. "Our critical review on the limited existing treatment mechanism studies," explained co-author Dr. Jessica Black, "found that 'common' processes, such as positive social support, rather than a particular treatment modality, account for positive adolescent substance use outcomes."

As for the future of adolescent substance use treatment, Drs. Chung & Black describe a need to focus on the "active ingredients" of therapies and their respective "targets." In addition, practitioners need to gain a better handle on the interaction between these aspects of specific therapies, overarching "common processes" like positive social support, and patients' lives outside of treatment.

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Story Source:

The above story is based on materials provided by Taylor & Francis. Note: Materials may be edited for content and length.

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Journal Reference:

1. Jessica J. Black, Tammy Chung. Mechanisms of change in adolescent substance use treatment: How does treatment work? Substance Abuse, 2014; 00 DOI: 10.1080/08897077.2014.925029

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Secret to raising well behaved teens? Maximize their zzzzz's

 

September 26, 2014

Taylor & Francis

While American pediatricians warn sleep deprivation can stack the deck against teenagers, a new study reveals youth’s irritability and laziness aren’t down to attitude problems but lack of sleep. This paper exposes the negative consequences of sleep deprivation caused by early school bells, and shows that altering education times not only perks up teens’ mood, but also enhances learning and health.

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In puberty, shifts in our body clocks push optimal sleep later into the evening, making it extremely difficult for most teenagers to fall asleep before 11.00pm. This, coupled with early school starts in the morning, results in chronically sleep-deprived and cranky teens as well as plummeting grades and health problems.

While American pediatricians warn sleep deprivation can stack the deck against teenagers, a new study from Taylor & Francis reveals youth's irritability and laziness aren't down to attitude problems but lack of sleep.

Recently published in the journal of Learning, Media and Technology, this interesting paper exposes the negative consequences of sleep deprivation caused by early school bells, and shows that altering education times not only perks up teens' mood, but also enhances learning and health.

It is no secret that human biology and education measure time in different ways; however, 'our ability to function optimally [and learn], varies with biological time rather than conventional social times', explain the team leading the research. When the two are more closely aligned, like in the early years of education, this is not so critical.

But things drastically change during adolescence, when 'the conflict between social and biological time is greater than at any point in our lives', continue the academics. Our sleep-wake cycle, or circadian rhythm, is the result of a complex balance between states of alertness and sleepiness regulated by a part of the brain called Suprachiasmatic Nucleus (SNC); in puberty, shifts in our body clocks push optimal sleep later into the evening, making it extremely difficult for most teenagers to fall asleep before 11.00pm. This, coupled with early school starts in the morning, results in chronically sleep-deprived and cranky teens as well as plummeting grades and health problems.

There is a body of evidence showing the benefits of synchronizing education times with teens' body clocks; interestingly, while 'studies of later start times have consistently reported benefits to adolescent sleep health and learning, there [is no evidence] showing early starts have a positive impact on such things', add the researchers. In spite of examples corroborating this theory -- crucial is the case of the United States Air Force Academy where a later start policy has been instrumental in trumpeting the marks of a group of 18-19 year olds -- educators still fail to grasp it's not laziness that keeps teens in bed in the morning but their biological clocks.

However, regardless of reluctance to alter the way things have always been done, a number of initiatives -- including the Start School Later campaign and the establishment of the National Sleep Foundation -- indicate a change may be in the air for education policies and practices in the US.

'Good policies should be based on good evidence and the data show that children are currently placed at an enormous disadvantage by being forced to keep inappropriate education times', argue the team. Will priorities be reshuffled to allow teenagers to cop some more z's then? This still remains to be seen.

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Story Source:

The above story is based on materials provided by Taylor & Francis. Note: Materials may be edited for content and length.

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Journal Reference:

1. Paul Kelley, Steven W. Lockley, Russell G. Foster, Jonathan Kelley. Synchronizing education to adolescent biology: ‘let teens sleep, start school later’. Learning, Media and Technology, 2014; 1 DOI: 10.1080/17439884.2014.942666

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Narrow focus on physical activity could be ruining kids' playtime

 

September 21, 2014

University of Montreal

While public health authorities focus on the physical activity benefits of active play, a new study reveals that for children, playing has no goal -- it is an end in itself, an activity that is fun, done alone or with friends, and it represents "an opportunity to experience excitement or pleasure, but also to combat boredom, sadness, fear, or loneliness."'By focusing on the physical activity aspect of play, authorities put aside several aspects of play that are beneficial to young people's emotional and social health,' says a professor.

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While public health authorities focus on the physical activity benefits of active play, a new study from the University of Montreal reveals that for children, playing has no goal -- it is an end in itself, an activity that is fun, done alone or with friends, and it represents "an opportunity to experience excitement or pleasure, but also to combat boredom, sadness, fear, or loneliness." "By focusing on the physical activity aspect of play, authorities put aside several aspects of play that are beneficial to young people's emotional and social health," explains Professor Katherine Frohlich of the university's Department of Social and Preventive Medicine, who supervised the study. "Play is a way to achieve various objectives, including the improvement of physical health and the development of cognitive and social aptitudes. Obviously, we must ensure children's development and combat obesity. But to get there, must we distort play?"

The study involved a photography and interview project with 25 Montreal area children, aged 7 to 11 years, as they photographed and talked about their favourite ways to play. One 10 year old girl loved climbing on a modern art sculpture near her home, for example. "Play is an activity that brings pleasure and is purposeless," explained the study's first author Dr. Stephanie Alexander, also of the university's Department of Social and Preventive Medicine. Children's photographs of their leisure activities show that sports are well represented -- balls, bicycles, hockey, and baseball -- but so are many sedentary activities, such as puzzles, knitting, reading, movies, and video games. Animals and pets were also photographed by many.

The semi-structured interviews allowed Alexander to better understand the meaning of play for the children. "Play reframed as a way for improving physical health removes the spontaneity, fun, and freedom in children's play, which is also important for their well-being," Alexander said. "Active play alone does not make up many children's preferences." It is also clear that risk-taking is an integral part of children's play preferences. "Allowing children to take acceptable risks while remaining vigilant is indeed beneficial to their development," Alexander added. "An overemphasis on safety may contribute to the emergence of a generation of young people that is less and less able to cope with the unpredictable."

In summary, the researchers identified four dimensions of play particularly important to children: play as an end in itself (children play for fun, not for exercise or for developing their mental and social skills); play isn't necessarily active (many children also enjoy more sedentary games); children feel ambiguous about scheduled play activities (children have little time for free play); and risk is considered a pleasurable component of their play. "Despite the abundance of messages targeting children and play and health, children's perspectives are rarely taken into account within public health, although they have social and scientific value," Frohlich said. "We hope that our findings will inform and improve the way authorities and indeed parents approach playtime."

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Story Source:

The above story is based on materials provided by University of Montreal. Note: Materials may be edited for content and length.

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Journal Reference:

1. S. A. Alexander, K. L. Frohlich, C. Fusco. Problematizing "Play-for-Health" Discourses Through Children's Photo-Elicited Narratives. Qualitative Health Research, 2014; 24 (10): 1329 DOI: 10.1177/1049732314546753

Inside the teenage brain: New studies explain risky behavior

 

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Young man (stock image). "Psychologists, psychiatrists, educators, neuroscientists, criminal justice professionals and parents are engaged in a daily struggle to understand and solve the enigma of teenage risky behaviors," Bhide said. "Such behaviors impact not only the teenagers who obviously put themselves at serious and lasting risk but also families and societies in general.

It's common knowledge that teenage boys seem predisposed to risky behaviors. Now, a series of new studies is shedding light on specific brain mechanisms that help to explain what might be going on inside juvenile male brains.

Florida State University College of Medicine Neuroscientist Pradeep Bhide brought together some of the world's foremost researchers in a quest to explain why teenagers -- boys, in particular -- often behave erratically.

The result is a series of 19 studies that approached the question from multiple scientific domains, including psychology, neurochemistry, brain imaging, clinical neuroscience and neurobiology. The studies are published in a special volume of Developmental Neuroscience, "Teenage Brains: Think Different?"

"Psychologists, psychiatrists, educators, neuroscientists, criminal justice professionals and parents are engaged in a daily struggle to understand and solve the enigma of teenage risky behaviors," Bhide said. "Such behaviors impact not only the teenagers who obviously put themselves at serious and lasting risk but also families and societies in general.

"The emotional and economic burdens of such behaviors are quite huge. The research described in this book offers clues to what may cause such maladaptive behaviors and how one may be able to devise methods of countering, avoiding or modifying these behaviors."

An example of findings published in the book that provide new insights about the inner workings of a teenage boy's brain:

• Unlike children or adults, teenage boys show enhanced activity in the part of the brain that controls emotions when confronted with a threat. Magnetic resonance scanner readings in one study revealed that the level of activity in the limbic brain of adolescent males reacting to threat, even when they've been told not to respond to it, was strikingly different from that in adult men.

• Using brain activity measurements, another team of researchers found that teenage boys were mostly immune to the threat of punishment but hypersensitive to the possibility of large gains from gambling. The results question the effectiveness of punishment as a deterrent for risky or deviant behavior in adolescent boys.

• Another study demonstrated that a molecule known to be vital in developing fear of dangerous situations is less active in adolescent male brains. These findings point towards neurochemical differences between teenage and adult brains, which may underlie the complex behaviors exhibited by teenagers.

"The new studies illustrate the neurobiological basis of some of the more unusual but well-known behaviors exhibited by our teenagers," Bhide said. "Stress, hormonal changes, complexities of psycho-social environment and peer-pressure all contribute to the challenges of assimilation faced by teenagers.

"These studies attempt to isolate, examine and understand some of these potential causes of a teenager's complex conundrum. The research sheds light on how we may be able to better interact with teenagers at home or outside the home, how to design educational strategies and how best to treat or modify a teenager's maladaptive behavior."

Bhide conceived and edited "Teenage Brains: Think Different?" His co-editors were Barry Kasofsky and B.J. Casey, both of Weill Medical College at Cornell University. The book was published by Karger Medical and Scientific Publisher of Basel, Switzerland. More information on the book can be found at: http://www.karger.com/Book/Home/261996

The table of contents to the special journal volume can be found at: http://www.karger.com/Journal/Issue/261977

 

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Story Source:

The above story is based on materials provided by Florida State University. Note: Materials may be edited for content and length.