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
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
A new study has found that a majority of family members and caregivers of children with atopic dermatitis, the most common form of eczema, suffer from anxiety and depression.
For the study, researchers from the PHI University Clinic of Dermatology assessed the impact of an atopic dermatitis diagnosis on the families of 35 children between the ages of 1 and 6. The researchers, who evaluated 83 family members and caregivers, found that all of them reported at least mild severity anxiety, with some showing moderate severity anxiety. Almost three in four — 74 percent — were also found to have depression.
According to the study’s findings, depression and anxiety scores were associated with the persistence and longevity of atopic dermatitis.
The researchers noted they did not find an association between scores and the severity of the disease, meaning that depression or anxiety was not observed to increase where atopic dermatitis was more severe.
Atopic dermatitis, the most common form of eczema, affects between 10 and 20 percent of the pediatric population of Europe. It causes the skin to become itchy, red, dry, and cracked. It is a chronic condition that most often occurs in people who have allergies and can develop alongside asthma and hay fever.
Patients with the condition are also known to suffer insomnia, anxiety, and psychosocial stress, linked to the physical manifestation of their eczema, according to the researchers.
For the study, researchers used the Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating scale (HAM-A).
The researchers also asked participants what their greatest concerns were. The most frequent worry was the information families and caregivers receive about the nature of the disease, since atopic dermatitis is a long-term condition that requires complex and costly medical treatments.
“The chronicity and complexity of chronic dermatitis often leads to overlooked anxiety and depression in family members and caregivers, but our results show the extent of this cannot be overstated,” said lead researcher Dr. Vesna Grivcheva-Panovska.
“In the future, we must take a widened approach to the management of atopic dermatitis, not only of the patients but of their families as well.”
The research was presented at the 2019 European Academy of Dermatology and Venereology (EADV) Congress.
Source: Spink Health
Heart patients with depression, anxiety or stress are more likely to drop out of cardiac rehabilitation, according to a new Australian study published in the European Journal of Preventive Cardiology.
Cardiac rehabilitation is a medically supervised program designed to improve cardiovascular health for patients who have experienced a heart attack, heart failure, angioplasty or heart surgery.
For the study, researchers examined the prevalence and impact of depression, anxiety and stress in patients attending cardiac rehabilitation at two hospitals in Sydney, Australia between 2006 and 2017. A total of 4,784 patients completed the Depression Anxiety Stress Scale questionnaire.
The findings show that approximately 18%, 28% and 13% of participants had moderate to extremely severe depression, anxiety or stress, respectively.
Patients with moderate symptoms of depression (24% versus 13%), anxiety (32% versus 23%) or stress (18% versus 10%) were significantly more likely to quit cardiac rehabilitation compared to those with no or mild symptoms.
“Heart patients living with depression are more likely to feel despondent and hopeless, which reduces their ability to manage their symptoms,” said study author Angela Rao, of the University of Technology Sydney, Australia.
“They may minimize successes and exaggerate failures, thereby reducing their motivation to exercise and complete a cardiac rehabilitation program.”
“Anxiety may lead to fear of another cardiac event and stop people from being active,” she continued. “Depression and anxiety can also impair the ability to retain new information needed to make health-related behavior changes.”
After a heart attack or procedure to open blocked arteries, patients should be encouraged to quit smoking, take up exercise, improve their diet, reduce stress, and control blood pressure and cholesterol; these can be achieved through cardiac rehabilitation.
“Depression can dampen positive intentions to exercise even when receiving support from health professionals and being aware of the benefits,” said Rao.
“People with anxiety may underestimate their abilities, for example to walk on a treadmill during a rehabilitation class.”
Around one half of patients with moderate depression or anxiety who completed cardiac rehabilitation did not show significant improvements in these conditions.
Depression, anxiety and stress were related, with one increasing the likelihood of the other. Patients with anxiety or stress were more than four times more likely to be depressed than those without.
Anxiety was three times more common in patients with (versus without) depression and more than five times more frequent in patients with (versus without) stress.
“These relationships were independent of age, sex, clinical characteristics, medication use and quality of life,” said Rao.
Rao urges clinicians to screen for depression and anxiety at the beginning and end of rehabilitation to identify those needing extra help. Stress management, cognitive-behavioral therapies, meditation and mindfulness can be included to improve mental health and raise participation.
Source: European Society of Cardiology
New research finds that performance anticipation at work or school may hinder your ability to remember what happened before your presentation or performance. Investigators also discovered that the presence of an audience may be an important factor in pre-performance memory deficit.
University of Waterloo researchers designed the study to explore what is called the next-in-line effect. “Performance anticipation could weaken memory because people tend to focus on the details of their upcoming presentation instead of paying attention to information that occurs before their performance,” says lead author Noah Forrin.
“People who experience performance anxiety may be particularly likely to experience this phenomenon.”
Forrin and his co-authors experimented with a variety of techniques that enhance memory, including the production effect — we can remember something best if we say it aloud.
One of the study’s co-authors, psychology professor Colin MacLeod, coined the term production effect from previous research. Prior studies have identified that reading aloud involves at least three distinct processes that help to encode memory: articulation, audition and self-reference.
Research by Forrin and MacLeod has demonstrated that reading aloud is better for memory than reading silently, writing, or hearing another person speak aloud. In the new study, however, the findings suggest that the production effect has a downside: When people anticipate reading aloud, they may have worse memory for information they encounter before reading aloud.
The researchers conducted four experiments with 400 undergraduate students and found that students have worse memory for words that they read silently when they anticipate having to read upcoming words aloud (compared to when they anticipate having to read upcoming words silently).
“Our results show that performance anticipation may be detrimental to effective memory encoding strategies,” said Forrin. “Students frequently have upcoming performances — whether for class presentations or the expectation of class participation.”
“We are currently examining whether the anticipation of those future performances reduces students’ learning and memory in the classroom.”
Forrin suggests that a strategy to avoid pre-performance memory deficits relates to scheduling.
“Try to get your performance over with by being the first student in class (or employee in a meeting) to present. After that, you can focus on others’ presentations without anticipating your own.”
The paper, “Wait for it… performance anticipation reduces recognition memory,” appears in the Journal of Memory and Language.
Source: University of Waterloo
A new study suggests that experiencing an annual income drop of 25 percent or more during young adulthood may increase the risk of developing thinking problems and reduced brain health in middle age.
“Income volatility is at a record level since the early 1980s and there is growing evidence that it may have pervasive effects on health,” said study senior author Adina Zeki Al Hazzouri, Ph.D., assistant professor of epidemiology at Columbia Mailman School of Public Health.
“Our study followed participants in the United States over 30 years, including the recession time in the late 2000s when many people experienced financial instability. Our results provide evidence that higher income volatility during peak earning years are associated with worse brain aging in middle age.”
The study, which appears online in Neurology®, involved 3,287 people who were 23 to 35 years old at the start of the study. Participants were enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study, which includes a racially diverse population.
Study members reported their annual pre-tax household income every three to five years for 20 years, from 1990 to 2010.
Researchers examined how often income dropped as well as the percentage of change in income between 1990 and 2010 for each participant. Based on the number of income drops, participants fell into three groups: 1,780 people who did not have an income drop; 1,108 who had one drop of 25 percent or more from the previous reported income; and 399 people who had two or more such drops.
Participants were given thinking and memory tests that measured how well they completed tasks and how much time it took to complete them. For one test, participants used a key that paired numbers 1 to 9 with symbols. They were then given a list of numbers and had to write down the corresponding symbols.
Researchers found that people with two or more income drops had worse performances in completing tasks than people with no income drops. On average, they scored worse by 3.74 points or 2.8 percent.
“For reference, this poor performance is greater than what is normally seen due to one year in aging, which is equivalent to scoring worse by only 0.71 points on average or 0.53 percent,” said first author Leslie Grasset, Ph.D., of the Inserm Research Center in Bordeaux, France.
Participants with more income drops also scored worse on how much time it took to complete some tasks.
The results were the same after researchers adjusted for other factors that could affect thinking skills, such as high blood pressure, education level, physical activity and smoking.
There was no difference between the groups on tests that measured verbal memory.
Of the study group, 707 participants also had brain scans with magnetic resonance imaging (MRI) at the beginning of the study and 20 years later to measure their total brain volume as well as the volumes of various areas of the brain.
Researchers found when compared to people with no income drops, people with two or more income drops had smaller total brain volume. People with one or more income drops also had reduced connectivity in the brain, meaning there were fewer connections between different areas of the brain.
According to the researchers, there may be several explanations as to why an unstable income may have an influence on brain health. Potential influences may include that people with a lower or unstable income could have reduced access to high quality health care. This could result in worse management of diseases like diabetes, or management of unhealthy behaviors such as smoking and drinking.
While the study does not prove that drops in income cause reduced brain health, it does reinforce the need for additional studies examining the role that social and financial factors play in brain aging.
Source: Columbia University Mailman School of Public Health/EurekAlert