Osteoarthritis May Play a Role in Social Isolation

When older adults become socially isolated, their health and well-being can suffer. Now a new study suggests a link between being socially isolated and osteoarthritis (arthritis), a condition that causes joint pain and can limit a person’s ability to get around.

The findings are published in the Journal of the American Geriatrics Society.

Arthritis patients often have other health issues which may increase their risk of becoming socially isolated. These include anxiety and depression, being afraid to move around (because arthritis makes moving painful), physical inactivity and being unable to take care of themselves.

About 30 percent of adults over 65 have arthritis to some degree, especially in their leg joints. Despite that, until now there has been little research on the link between arthritis and social isolation.

Researchers analyzed data from the European Project on OSteoArthritis (EPOSA) study. They wanted to examine any potential links between arthritis and social isolation, and to identify the disease’s contribution to social isolation.

EPOSA is a study of 2,942 adults between the ages of 65 to 85 years old who live in six European countries: Germany, Italy, the Netherlands, Spain, Sweden, and the UK. In all, 1,967 people, around the age of 73, participated in the study. Half of the participants were women, and almost 30 percent had arthritis.

The researchers looked at whether the participants were socially isolated at the beginning of the study as well as 12 to 18 months later. The participants completed questionnaires that kept track of how often they connected socially with friends and family members and how often they volunteered or participated in social activities.

At the start of the study, almost 20 percent were socially isolated. Those who weren’t socially isolated tended to be younger, had higher incomes and more education. They were also more likely to be physically active, had less physical pain, had faster walking times and were in better all-around health.

Of the 1,585 participants who weren’t considered socially isolated at the beginning of the study, 13 percent had become socially isolated 12 to 18 months later. They reported that their health and osteoarthritis had worsened, they were in more pain, had become less physically active, had slower walking times, and had depression and problems with thinking and making decisions.

The researchers say the findings suggest that osteoarthritis can increase the risk of social isolation. In particular, having problems with thinking and making decisions, as well as having slower walking times, is associated with an increased risk of becoming socially isolated.

Since social isolation can lead to poorer health, the researchers suggest that older adults with arthritis may benefit from engaging in physical activity and social activities. Specifically, they suggest that health care providers might refer people to senior centers where activities are specially designed for people with arthritis.

Source: American Geriatrics Society

 

Hope Can Aid in Recovery from Anxiety Disorders

New research suggests hope is a trait that can predict resilience and recovery from anxiety disorders.

In a new study, clinical psychologist Dr. Matthew Gallager and colleagues examined the role of hope in predicting recovery in a clinical trial of adults in cognitive behavior therapy (CBT) for common anxiety disorders.

Historically, the concept of hope has long stirred opinion. In the 16th century, German theologian Martin Luther celebrated its power, claiming “Everything that is done in this world is done by hope.” Two centuries later, Benjamin Franklin warned that “He that lives upon hope will die fasting.”

In the study, Gallagher — University of Houston associate professor of clinical psychology — assessed the role of hope in predicting recovery among a clinical trial of 223 adults. In the trial, adults were receiving cognitive-behavior therapy (CBT) for one of four common anxiety disorders: social anxiety disorder, panic disorder, generalized anxiety disorder and obsessive-compulsive disorder.

Gallagher discovered that psychotherapy can result in clear increases in hope and that changes in hope are associated with changes in anxiety symptoms. His findings appear in the journal Behavior Therapy.

“In reviewing recovery during CBT among the diverse clinical presentations, hope was a common element and a strong predictor of recovery,” said Gallagher. He also reports that moderate-to-large increases in hope and changes in hope were consistent across the five separate CBT treatment protocols.

In terms of psychotherapy, hope represents the capacity of patients to identify strategies or pathways to achieve goals and the motivation to effectively pursue those pathways.

Significantly, the results of this study indicate that hope gradually increases during the course of CBT, and increases in hope were greater for those in active treatment than for those in the waitlist comparison.

The magnitude of these changes in hope were consistent across different CBT protocols and across the four anxiety disorders examined, which underscores the broad relevance of instilling hope as an important factor in promoting recovery during psychotherapy.

“Our results can lead to a better understanding of how people are recovering and it’s something therapists can monitor. If a therapist is working with a client who isn’t making progress, or is stuck in some way, hope might be an important mechanism to guide the patient forward toward recovery,” said Gallagher.

Hope is closely related to other positive psychology constructs, such as self-efficacy and optimism, that have also been shown to have clear relevance to promoting resilience to and recovery from emotional disorders, said Gallagher.

Gallagher’s research is part of a larger project examining the efficacy of CBT for anxiety disorders led by Dr. David H. Barlow, founder and director emeritus of the Boston University Center for Anxiety and Related Disorders.

Source: University of Houston

Solitary Confinement Tied to Greater Risk of Death After Prison Release

Prisoners who are held in restrictive housing (i.e., solitary confinement) face an increased risk of death after their release, according to a new study led by researchers from the University of North Carolina (UNC) at Chapel Hill.

The findings show that incarcerated individuals who were placed in restrictive housing in North Carolina from 2000 to 2015 were 24% more likely to die in the first year after their release, compared to those who were not held in restrictive housing.

In addition, those held in restrictive housing were 78% more likely to die from suicide, 54% more likely to die from homicide, and 127% more likely to die from an opioid overdose in the first two weeks after their release.

Further, the number of restrictive housing placements and spending more than 14 consecutive days in restrictive housing were associated with an even greater increase in the risk of death and reincarceration.

“For the first time ever, using data shared with us from our partners at the North Carolina Department of Public Safety, we’ve been able to demonstrate a connection between restrictive housing during incarceration and increased risk of death when people return to the community,” said lead author Lauren Brinkley-Rubinstein, PhD, an assistant professor of social medicine in the UNC School of Medicine.

“In addition, our study found that the more time people spent in restrictive housing the higher the risk of mortality after release. This study provides empirical evidence to support ongoing nationwide reforms that limit the use of restrictive housing.”

“North Carolina is a leader in this thinking as the Department of Public Safety has preemptively implemented multiple reforms that have resulted in the limited use of restrictive housing.”

“We appreciate this research collaboration and recognize the importance of these results in shaping policy and practice,” said Gary Junker, PhD, Director of Behavioral Health for the N.C. Department of Public Safety Adult Correction and Juvenile Justice.

“Since 2015, the department has initiated several programs to divert people from restrictive housing, including Therapeutic Diversion Units for those with mental illness. While safety and security must remain our top priority, we recognize that reduced use of restrictive housing will likely improve post-release outcome.”

These findings, published in the journal JAMA Network Open, are from a retrospective cohort study conducted by Brinkley-Rubinstein and co-authors from UNC, Emory University, the N.C. Department of Public Safety and the N.C. Department of Public Health.

Incarceration data for people who were confined in North Carolina between 2000 and 2015 were matched with death records from 2000 to 2016.

“We also found that non-white individuals were disproportionately more likely to be assigned to restrictive housing than their white counterparts,” said co-author Shabbar Ranapurwala, PhD, MPH, an assistant professor of epidemiology in the UNC Gillings School of Global Public Health and a core faculty member of the UNC Injury Prevention Research Center.

“In fact, the mortality and reincarceration outcomes after release were also quite different between these racial groups. The post-release opioid overdose and suicide death outcomes among those receiving restrictive housing were more pronounced among white individuals compared to non-whites, while the all-cause and homicide death and reincarceration outcomes were higher among non-white Americans compared to whites.”

Given the observational nature of the study, establishing cause and effect may be difficult, yet, the strength and consistency of the findings points to the fact that restrictive housing is an important marker of increased mortality risk among formerly incarcerated individuals.

Source: University of North Carolina Health Care

Rest After Trauma May Help Decrease PTSD Symptoms

New research suggests a period of rest following a traumatic event can help reduce the subsequent development of involuntary “memory intrusions,” a frequent symptom of post-traumatic stress disorder. Memory intrusions can be both visual or non-visual and are often referred to as flashbacks.

The study, published in Scientific Reports, discovered memory disturbances in PTSD may be mitigated by a process that occurs in the brain that can be facilitated by rest and sleep. Specifically, investigators discovered increased consolidation — storage and contextualization of memories in the brain — helps to alleviate memory intrusions. Experts believe this finding could shed new light on treatment and prevention.

Lead author Dr. Lone Hørlyck, from the Institute of Cognitive Neuroscience at University College London, said, “Over a lifetime, many people experience traumatic events, but most people do not develop persistent trauma symptoms.

“Identifying which mechanisms might contribute to memory intrusions in PTSD is important, as these disturbances comprise an important maintaining factor in the disorder.”

For the study, researchers presented 85 participants with emotionally negative videos, followed by either a period of wakeful rest or a simple control task, where participants were required to pay attention to numbers on a screen.

The videos comprised highly emotional content, such as badly injured people or serious accidents.

Researchers found that participants who had a period of rest following the viewing of negative videos reported fewer memory intrusions related to the videos over the following week.

In contrast, there was no difference between rest and the simple control task on a follow-up memory test assessing how much participants remembered when they wanted to.

Rest and certain phases of sleep are known to increase processing in the hippocampus, a key region of the brain that helps put memory in context.

According to the investigators, the results suggest that a strengthening of this contextual memory system is beneficial in preventing memory intrusions following trauma.

Senior author Professor Neil Burgess, of the Institute of Cognitive Neuroscience, said, “The coherence of memories is often compromised when people are exposed to psychological trauma, resulting in emotional memories popping up involuntarily and out of context.

“However, the binding of an event memory with its context may be partly restored with rest, facilitating deliberate control of the memory.

“The results show that specific brain systems could be targeted to reduce development of PTSD and may explain why treatments that focus on re-exposure and integrating the trauma with other information are beneficial.”

Hørlyck added, “Our findings contribute to a better understanding of the mechanisms that are at play when some people develop memory disturbances following trauma while others do not.”

Source: University College London/EurekAlert

Two-Year-Olds From Poor Neighborhoods More Likely to Have Language Difficulties

Two-year-olds from disadvantaged backgrounds are three times more likely to develop difficulties with language than those from more affluent areas, according to a new Scottish study published in the journal JAMA Network Open.

Researchers say the findings highlight the need for policy makers to address the social factors that can hinder speech, language and communication (SLC) development.

Failing to do so means children might not fully develop the language skills necessary for emotional development, wellbeing and educational and employment opportunities.

“Growing up in a disadvantaged neighbourhood where there is poverty and reduced access to services is closely associated with problems with preschool language development,” said Professor James Boardman of Neonatal Medicine at the University of Edinburgh’s MRC Centre for Reproductive Health.

“These results suggest that policies designed to lessen deprivation could reduce language and communication difficulties among pre-school children.”

For the study, a research team from the University of Edinburgh and NHS Lothian in Scotland looked at more than 26,000 records of children who had received a routine health review between 27 and 30 months between April 2013 and April 2016.

The findings show that two-year-olds living in the most economically deprived neighborhoods were three times more likely to have SLC concerns compared to those brought up in better-off areas.

It is believed that growing up in neighborhoods with low income and unemployment — which is related to problems with education, health, access to services, crime and housing — can increase the risk of setbacks.

The researchers also discovered that being born prematurely had an impact on language issues. The findings show that each week a child spent in the womb from 23 to 36 weeks was associated with an 8.8% reduction in the likelihood of the children having an SLC concern reported at 27 months.

A pregnancy is considered full term between 39 weeks and 40 weeks, 6 days, while preterm birth is defined as delivery before 37 weeks of gestation. Socioeconomic disadvantage has also been associated with a greater risk for preterm birth.

Although the research team looked at birth data from children born in the Lothians, experts say similar results might be expected across the United Kingdom.

Source: University of Edinburgh

Study: Competitive People Have Higher Risk for Using Drugs

A new study from Spain suggests hostile and competitive people are more likely to abuse drugs and alcohol.

“There are still many questions to answer but what we discovered is very significant,” points out Dr. Rosario Ruiz Olivares, head researcher at the University of Cordoba (Spain). Nevertheless, Olivares said that what could be called an addictive personality “does not exist.”

However, the study does confirm that there is a very strong correlation between a personality characterized by hostility and competitiveness and consumption of illegal substances, such as cocaine, cannabis and hallucinogens.

Investigators believe that people who are patient, less hostile, and not competitive have a much lower likelihood of being drug users. “This kind of personality is a protective factor for drug consumption and is especially meaningful in the case of alcohol and tobacco,” Olivares said.

In the study, socio-demographic and personality questionnaires were completed by 3,816 young people in the province of Cordoba between the ages of 18 and 29. “In the future, we would like to broaden the sample to a national level and study behavior patterns according to the person’s gender,” states Rosario Ruiz.

These results represent an important step in the field of preventing drug consumption among young people, since it could focus specifically on people who demonstrate hostile and competitive traits.

Furthermore, it will not only help in prevention, but may also help clinicians given that individuals who have these characteristics can find it more difficult to overcome their addiction. Early detection of substance abuse can lead to specific psychological therapy designed to work on the personality traits that influence drug abuse.

Source: University of Cordoba