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Responding to Violence, Suicide, Psychosis and Trauma

Anger And Hostility Harmful To The Heart, Especially Among Men

Anger And Hostility Harmful To The Heart, Especially Among Men

ScienceDaily (Mar. 16, 2009) — Anger and hostility are significantly associated with both a higher risk for coronary heart disease (CHD) in healthy individuals and poorer outcomes in patients with existing heart disease, according to the first quantitative review and meta-analysis of related studies, which appears in the March 17, 2009, issue of the Journal of the American College of Cardiology.

Management of anger and hostility may be an important adjuvant strategy in preventing CHD in the general public and treating CHD patients, according to authors.

“Anger and hostility were found to predict a 19 percent and 24 percent increase in CHD events among initially healthy people and those with pre-existing CHD, respectively,” says Yoichi Chida, M.D., Ph.D., Department of Epidemiology & Public Health, University College, London, UK. “The harmful association of anger and hostility with CHD events in healthy people was greater in men than women. This suggests that the accumulation of stress responses in daily life might have a greater impact on future CHD in men.”

Authors extensively reviewed the literature on the longitudinal associations of anger and hostility with CHD events, and identified 25 studies of initially healthy populations and 18 studies of patients with CHD. While the damaging effects of these emotions have been widely asserted, previous reviews have been inconclusive.

“This review provides further evidence that psychological factors do matter in the development and progression of CHD,” says Johan Denollet, Ph.D., CoRPS research center, Tilburg University, The Netherlands, and co-author of the accompanying editorial. “Clinicians should take symptoms of anger and hostility seriously, and may consider referring their patient for behavioral intervention. We need to closely monitor and study these personality traits in order to do a better job at identifying high-risk patients who are more liable to future fatal and non-fatal coronary events.”

Interestingly, there was no longer a significant association of anger and hostility with CHD when researchers performed a subgroup analysis of the studies that controlled for behavioral covariates (e.g., smoking, physical activity or body mass index, socioeconomic status) and disease treatment, suggesting that the major pathway between anger and hostility and CHD might be behavioral risk factors. In addition, a direct physiological pathway should be considered in future studies; this might involve autonomic nervous dysregulation, increases in inflammatory or coagulation factors such as C-reactive protein, interleukin 6 and fibrinogen, and higher cortisol levels.

Future research should also focus on the interplay between negative emotions and emotion regulation strategies as a determinant of major coronary events, according to Denollet.

Journal references:

1. Yoichi Chida and Andrew Steptoe. The Association of Anger and Hostility With Future Coronary Heart Disease: A Meta-Analytic Review of Prospective Evidence. J Am Coll Cardiol, 2009; 53: 936-946 [link]
2. Johan Denollet and Susanne S. Pedersen. Anger, Depression, and Anxiety in Cardiac Patients: The Complexity of Individual Differences in Psychological Risk. J Am Coll Cardiol, 2009; 53: 947-949 [link]

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Filed under: Violence

Tiny Brain Region Key To Fear Of Rivals And Predators

ScienceDaily (Mar. 15, 2009) — Mice lose their fear of territorial rivals when a tiny piece of their brain is neutralized, a new study reports.

The study adds to evidence that primal fear responses do not depend on the amygdala – long a favored region of fear researchers – but on an obscure corner of the primeval brain.

A group of neuroscientists led by Larry Swanson of the University of Southern California studied the brain activity of rats and mice exposed to cats, or to rival rodents defending their territory.

Both experiences activated neurons in the dorsal premammillary nucleus, part of an ancient brain region called the hypothalamus.

Swanson’s group then made tiny lesions in the same area. Those rodents behaved far differently.

“These animals are not afraid of a predator,” Swanson said. “It’s almost like they go up and shake hands with a predator.”

Lost fear of cats in rodents with such lesions has been observed before. More important for studies of social interaction, the study replicated the finding for male rats that wandered into another male’s territory.

Instead of adopting the usual passive pose, the intruder frequently stood upright and boxed with the resident male, avoided exposing his neck and back, and came back for more even when losing.

“It’s amazing that these lesions appear to abolish innate fear responses,” said Swanson, who added: “The same basic circuitry is found in primates and people that we find in rats and mice.”

The study was slated for online publication the week of March 9 in Proceedings of the National Academy of Sciences.

Swanson predicted that his group’s findings would shift some research away from the amygdala, a major target of fear studies for the past 30 years.

“This is a new perspective on what part of the brain controls fear,” he said.

He explained that most amygdala studies have focused on a different type of fear, which might more accurately be called caution or risk aversion.

In those studies, animals receive an electric shock to their feet. When placed in the same environment a few days later, they display caution and increased activity of the amygdala.

But the emotion experienced in that case may differ from the response to a physical attack.

“We’re not just dealing with one system that controls all fear,” Swanson said.

Swanson and collaborators have been studying the role of the hypothalamus in the fear response since 1992.

Because of its role in basic survival functions such as feeding, reproduction and the sleep-wake cycle, the hypothalamus seems a plausible candidate for fear studies.

Yet, said Swanson, “nobody’s paid any attention to it.”

The PNAS study is the most recent of several by Swanson on fear and the hypothalamus. The few other researchers in the area include Newton Canteras of the University of Sao Paulo in Brazil, who collaborated with Swanson on the PNAS study, as well as Robert and Caroline Blanchard of the University of Hawaii.

The other authors on the PNAS study were Simone Motta, Marina Goto, Flavia Gouveia and Marcus Baldo, all from the University of Sao Paulo.

The Brazilian government funded the study.

Journal reference:

1. Simone C. Motta, Marina Goto, Flavia V. Gouveia, Marcus V. C. Baldo, Newton S. Canteras, and Larry W. Swanson. Dissecting the brain’s fear system reveals the hypothalamus is critical for responding in subordinate conspecific intruders. Proceedings of the National Academy of Sciences, 2009; DOI: 10.1073/pnas.0900939106

Adapted from materials provided by University of Southern California.

Filed under: trauma, Violence, , , , ,

Reducing Suicidal Behaviors Among Adolescents

ScienceDaily (Mar. 15, 2009) — Adolescent girls who view themselves as too fat may display more suicidal behaviors than those who are actually overweight, according to a study by Inas Rashad, an assistant professor of economics at Georgia State University.

Although studies have shown a link between obesity, depressive disorders and suicidal behaviors, Rashad and Dhaval Dave of Bentley University, analyze these indicators in conjunction with an individual’s perception of their weight. The study, which was accepted for publication in February, will be published in Social Science and Medicine.

“Both obesity and suicide have been highlighted by the Surgeon General as areas of focus for adolescents and areas of great concern,” Rashad said. “We find that the role perception has independently of actual overweight status is an important one, which has implications in terms of any solutions to the obesity epidemic that are put forth.”

The researchers utilized data from 1999 to 2007 from the Youth Risk Behavioral Surveillance System, which indicated that 17 percent of high school students have seriously considered committing suicide. The data were used to not only investigate whether overweight status or perception are causal factors affecting suicidal thoughts and attempts among high school students, but also to estimate the potential economic costs.

“If being overweight not only imposes the usual health care and labor market costs, but also increases the risk of suicide, we need to take these costs into account when offering solutions,” Rashad said.

The study revealed that body dissatisfaction had a strong impact on all suicidal behaviors for girls and was generally insignificant for males. For instance, any perception of being overweight by girls raised the probability of suicidal thoughts by 5.6 percent, the probability of a suicide attempts by 3.2 percent, and the probability of an injury causing suicide attempts by 0.6 percent. The researchers also state that the risk of suicide by adolescent females could potentially add about $280 to $350 million to the costs of adolescent obesity, which includes the direct cost of illnesses and associated health care and indirect costs such as productivity losses, reduced income and premature mortality.

Rashad hopes more research will be done on the topic, but she recommends efforts aimed at preventing youth suicides focus on educating youths and fostering healthy attitudes with regard to weight.

“The prevalence of body dissatisfaction, among special populations of youths such as non-black girls, is significantly higher than the general youth population, even when the underlying weight is in a healthy range,” Rashad said. “Interventions that identify and assist these youths and educate them regarding a healthy body image will succeed in lowering suicide attempts.”
Adapted from materials provided by Georgia State University, via EurekAlert!, a service of AAAS.

Filed under: Suicide, , , , ,