Parents: Kids Spurn Emotional Help For Fear ‘They Might Think I’m The Next Shooter’

Candles spelling UCC -- for Umpqua Community College -- are displayed at a candlelight vigil for those killed during a fatal shooting at the school, Thursday in Roseburg, Oregon. (Rich Pedroncelli/AP)

Candles spelling UCC — for Umpqua Community College — are displayed at a candlelight vigil for those killed during a fatal shooting at the school in Roseburg, Oregon. (Rich Pedroncelli/AP)

By Lisa Lambert
Guest contributor

Lisa Lambert is the executive director of the Parent/Professional Advocacy League, which is subtitled “The Massachusetts Family Voice For Children’s Mental Health.”

“He doesn’t want to take the risk and have someone think he could be a shooter,” one mother said, “just because he has a mental health diagnosis.”

I was at a meeting with other parents whose children have mental health needs. This mother told us her son was reluctant to leave his high school classroom for an important evaluation, which included psychological testing.

Like much of America, we were talking about the recent and not-so-recent shootings on campuses and in communities across the country. For this mother, as with many parents whose children have mental health issues, the conversation is far more personal and troubling than for most.

Some parents said that in response to recent shooting incidents, their children are dropping out of services or refusing school supports so they won’t risk their peers or teachers finding out why they get treatment.

As a parent, this breaks my heart. Young adults shouldn’t have to choose between the safety found in avoiding treatment and the healing found in seeking it.

Lisa Lambert (courtesy)

Lisa Lambert (courtesy)

During our discussion, another mother reported that her son was in his first year of college and struggling to complete all his coursework. Freshman year is a stressful time for many students and even more so for students with depression. Because her son had had special education services in high school, he could access supports there to help him manage his academic and emotional stress.

She encouraged him to go to the college student services office to get help. He responded, “I’d rather drop the classes I am most behind in. If I go there, the professors and other students will know I have mental health problems. They might think I could be the next shooter.”

Often, as a news channel covers the latest shooting, the speculation immediately jumps to mental illness. Continue reading

Healthy Narcissism? 8 Ways To Be (A Bit) More Like Donald Trump

Donald Trump displays a copy of his net worth during his announcement that he will seek the Republican nomination for president, on June 16, in the lobby of Trump Tower in New York. (Richard Drew/AP)

Donald Trump displays a copy of his net worth during his announcement that he will seek the Republican nomination for president, on June 16, in the lobby of Trump Tower in New York. (Richard Drew/AP)

Donald Trump is often described as a textbook case of the downsides of extreme narcissism — the cruelty, the conceit. But the Republican presidential front-runner’s success in business and politics raises this uncomfortable question: What if he also exemplifies the upsides of narcissism? And what if it would behoove many of us to be a bit more like him?

Your knee-jerk response may be, “I don’t want to emulate Donald Trump in any way!” But can we take just the useful pages from his playbook and leave out the ugly parts?

I put that query to Dr. Craig Malkin, author of the new book, “Rethinking Narcissism: The Bad — And Surprising Good — About Feeling Special.” A clinical psychologist and instructor at Harvard Medical School, he begins with a massive disclaimer: “I would not advise anyone to emulate Donald Trump in a lot of the ways that he behaves.”

But broadly speaking, he says, it’s a myth that narcissism is all bad. In fact, narcissism is a trait, not a diagnosis, Malkin says; it’s a drive to feel special. And it exists on a spectrum, unhealthy mainly at the extremes.

“We are surrounded by this idea of empty, soulless, dangerous narcissists, and there are people like that out there,” he says. “But the reality is, what we see in the research is that there are healthy aspects, and they coexist, often, with the unhealthy in people who are extremely narcissistic. So you get the good with the bad.” Continue reading

CDC: One-Third Of Children With ADHD Diagnosed With The Disorder Before Age 6

(Vivian Chen/Flickr)

(Vivian Chen/Flickr)

One-third of children diagnosed with ADHD were diagnosed young — before the age of 6 — according to a new national survey from the U.S. Centers for Disease Control and Prevention.

Earlier, the CDC found that based on parental reports, 1 in 10 school-aged children, or 6.4 million kids in the U.S., have received a diagnosis of ADHD, a condition marked by symptoms including difficulty staying focused and paying attention, out of control behavior and over-activity or impulsivity.

The percentage of children diagnosed with ADHD has increased steadily since the late 1990s and jumped 42 percent from 2003-2004 to 2011-2012, the CDC says. Last year, concerns flared when a report found that thousands of toddlers are being medicated for ADHD outside of established pediatric practice guidelines.

In the current analysis, also based on parental reporting, and using data drawn from the 2014 National Survey of the Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder and Tourette Syndrome, the CDC also found:

•The median age at which children with ADHD were first diagnosed with the disorder was 7 years old

•The majority of children (53.1%) were first diagnosed by a primary care physician

•Children diagnosed before age 6 were more likely to have been diagnosed by a psychiatrist

•Children diagnosed at age 6 or older were more likely to have been diagnosed by a psychologist

•Among children diagnosed with ADHD, the initial concern about a child’s behavior was most commonly expressed by a family member (64.7%)

•Someone from school or daycare first expressed concern for about one-third of children later diagnosed with ADHD (30.1%)

•For approximately one out of five children (18.1%), only family members provided information to the child’s doctor during the ADHD assessment

What are we — parents, educators, doctors — to make of all this? In particular, what does it mean that so many very young kids are being diagnosed with an attention disorder? (Has anyone ever encountered a 4- or 5-year-old child who is not hyperactive, impulsive and inattentive??)

I asked two doctors — a pediatrician and a psychiatrist — for their impressions of the CDC report. Both agreed that we seem to have two problems when it comes to ADHD: over-diagnosing and under-diagnosing. Here, lightly edited, are their responses.

First, the pediatrician:

James M. Perrin, MD, is a professor of pediatrics at Harvard Medical School and associate chair of MassGeneral Hospital for Children. Dr. Perrin is also the immediate past president of the American Academy of Pediatrics and chaired the 1990s committee that wrote the first practice guidelines for ADHD (and he was on the committee for the 2011 revision).

RZ: How difficult is it to diagnose ADHD in children under 6 years old?

JP: In the pediatric community, we have worked over last 15 years to train general pediatricians to make diagnoses of ADHD reliably and follow very clear, specific guidelines on how to do so. In 2011, the AAP revised its practice guidelines for ADHD and included the opportunity to diagnose children ages 4 and 5 years old.

At the same time we recognize it’s very hard to do that well in that age group…because a lot of children are inattentive at 4 — you don’t expect them to work hard and read a Hardy boys book for an hour and half. Five is often impulsive, active, so it’s not unusual to have symptoms that children with ADHD would also have at age 4, 5. So, it’s not easy.

We did say [in the guidelines] pretty clearly that you shouldn’t make the diagnoses without significant impairment of normal behavior. What we mean by that is a child whose symptoms impair her ability to play with other children, or whose behavior is so out of control that it’s dangerous, for instance she runs out in front of cars, or has many accidents, that’s when the symptoms become impairing. Continue reading

Workout Supplements: Does Overuse Signal An Eating Disorder Among Men?



By Marina Renton
CommonHealth Intern

You’ve seen them at the gym: extremely body conscious men, driven to achieve a level of physical perfection through grueling workouts.

Well, new research suggests that overusing popular supplements like whey protein and creatine to improve workout performance may signal an emerging eating disorder.

Researchers presented their findings at the American Psychological Association’s annual convention in Toronto earlier this month.

Almost 200 18- to 65-year-old men who consumed legal appearance- and performance-enhancing drugs (APEDs) and worked out at least twice a week participated in the study, led by co-authors Richard Achiro and Peter Theodore, both from the California School of Professional Psychology at Alliant International University, Los Angeles. In addition to asking about their supplement use and eating habits, researchers surveyed the participants about their psychological well-being, asking about their body image, self-esteem and gender role conflicts.

Almost 30 percent of the people surveyed said they were worried about their supplement use. Over 40 percent had increased their supplement intake over time. Twenty-two percent said they consumed the supplements instead of a meal, even when that wasn’t their intended use. Eight percent had been advised by their doctor to curb their use of supplements, and 3 percent had been hospitalized for kidney or liver problems stemming from their supplement intake.

Continue reading

Sexting Among Adults May Be More Common Than You Think, Survey Suggests

A middle-aged woman I know recently confessed that she’s been doing quite a bit of provocative, R-rated texting with a man she’s involved with.

When I referred to it as “sexting” she was shocked. “It’s not like we’re sending naked pictures back and forth,” she said. “Just a little suggestive ‘What are you wearing?’ kind of thing. It’s fun.”

Welcome to the new world of sexting.

It turns out grownups in committed relationships are, increasingly, doing it for pleasure and “fun,” as one survey found. Also, according to researchers, the whole concept of “sexting” has evolved, or at least is evolving: from a risky, sordid and sometimes-dangerous activity among teens, to, as one therapist (more below) says, a way to add some sexual “simmering” to a relationship that may need spicing up. Even the AARP acknowledges the trend: “…the reality is that more and more of the 50-plus set, both single and married, routinely use text messaging to send tantalizing pictures and provocative words to their partner…”

Reframing Sexting

Indeed, sexting may be more popular among adults than you think.

A new survey on sexting found that 88 percent of respondents, ages 18-82, said they’d done it, and 82 percent said they’d done it in the past year (including the 82-year-old). Also, nearly 75 percent said they sexted in the context of a committed relationship, while 43 percent said they sexted as part of a casual relationship. (On the darker side, 12 percent reported sexting someone “in a cheating relationship.”) The findings were presented at the American Psychological Association annual convention in Toronto earlier this month in a paper called: “Reframing Sexting as a Positive Relationship Behavior.”

(Photo illustration by Mike Licht/Flickr, taking inspiration from the artist Edward Armitage)

(Photo illustration by Mike Licht/Flickr, taking inspiration from the artist Edward Armitage)

The survey of 870 heterosexual individuals in the U.S. also found that in general, more sexting was associated with a higher level of sexual satisfaction. More than half of the responses came from women; the average age of participants was 35, according to the study authors.

On one level, it’s not surprising that sexting is becoming more mainstream.

“If we look at how technology has been integrated into our society — it’s so much part of our daily lives — it makes sense that it would become part of our dating and sexual lives as well,” said Emily Stasko, MPH, a doctoral candidate in psychology at Drexel University in Philadelphia and the survey’s co-author, along with Pamela Geller, PhD, associate professor of psychology, ob/gyn and public health at Drexel.

Attitudes about sexting seem to be changing too. The survey found that people who sexted more rated it as more “carefree and fun” and had higher beliefs that sexting was expected in their relationships.

(Sexting, for the purposes of the survey, was defined broadly as sending or receiving sexually suggestive or explicit content via text message, mainly using a mobile device, Stasko said.)

Of course, this doesn’t mean that every grownup out there is under the covers with their phone at night shooting off racy texts. These survey findings are preliminary, and come with big caveats, Stasko says. The findings may not be representative: Participants were recruited online and responded to a posting asking them to take a survey about sexting, so the sample could be skewed toward more seasoned sexters.

Don’t Forget Pleasure

The main goal of the study was to look at sexting through a new filter, Stasko said. The practice has historically been viewed as a risky activity among teens, associated with other sexual risk-taking (like having unprotected sex) and negative health outcomes, like sexually transmitted infections. She said she and her colleagues wanted to reevaluate sexting in a new light — as a potential positive force in a relationship and a way to potentially enhance open sexual communication. “There seems to be a missing discourse about pleasure,” Stasko said. “We wanted to talk not just about risk, but also introduce the idea that pleasure is a part of it.”

The takeaway, she said, is that when sexting is wanted by both parties, is can be a good thing. “The findings show a robust relationship between sexting and sexual and relationship satisfaction,” the study concludes.

Sexual ‘Simmering’

Aline P. Zoldbrod, Ph.D., a certified sex therapist in Lexington, Massachusetts, agrees that sexting can play an important role in adult relationships.

I asked her for her thoughts on the survey, and here’s what she wrote:

Sexting is not just for hookups, as a follow up to an interlude on sex chat roulette or for trolling on Craigslist. Sexting actually has some amazing benefits for people in ongoing relationships.  Continue reading

Want Happiness At 50? Be A Social Butterfly At 20, Keep Friends Close At 30

(Seranya Photography/Flickr)

(Seranya Photography/Flickr)

By Marina Renton
CommonHealth Intern

What’s the key to happiness in middle age? Be a social butterfly when you’re 20 and keep your friends close at 30. That’s according to a new study looking at the health impacts of social networks over decades.

Researchers at the University of Rochester found that because our social goals change over time, a high quantity of social interactions at age 20 and a high quality of interactions at age 30 was associated with better social and psychological outcomes around age 50. The study appears in the journal Psychology and Aging.

A Pleasant Interaction? 

The study was 30 years in the making and began in the ’70s when college students were asked to keep a kind of diary where they logged all their social interactions over a two-week period. They recorded the length of their interactions, the level of intimacy and pleasantness, among other things. The diary method, officially called the Rochester Interaction Record, was designed to capture spontaneous social activity (think pre-Twitter). It was also an attempt to minimize “recall bias.”

Study co-author Cheryl Carmichael, an assistant professor of psychology at Brooklyn College and the Graduate Center of the City University of New York, explained why the “diaries” were important: “If I asked somebody, ‘Hey, how’s your social life going these days?’ it could very easily be colored by whatever their morning or afternoon was like,” she said. For instance, your social life might seem bleak if you’ve just argued with your best friend, but if you’ve have it all written down, you can get a more accurate sense of a person’s true social life. Continue reading

Brain Scientist: How Pixar’s ‘Inside Out’ Gets One Thing Deeply Wrong

By Lisa Feldman Barrett, PhD, with Daniel J. Barrett, PhD
Guest contributors

Pixar’s “Inside Out” is the latest in a long tradition of animated entertainment that teaches us about science.

Chemistry, as I learned from Saturday morning cartoons, is about mixing colorful, bubbling liquids in test tubes until they explode. “Roadrunner and Coyote” cartoons—those fine nature documentaries—taught me physics: If you run off a cliff, you’ll hang in mid-air until the unfortunate moment that you look down. Computer science is apparently about robots that kill you. And now, with “Inside Out,” we finally have cartoon neuroscience.

Your brain, it turns out, is populated with characters for each emotion, and they press buttons to control your expressions. This is all good fun and a sweet movie. What is surprising, however, is that some scientists have taken this model seriously for a century and actually search for these characters in the brain. Not as animated creatures, mind you, but as blobs of brain circuitry.

So happiness and fear are not brain blobs — they are whole-brain constructions.

This blob over here is your “fear circuit,” they say, or this other blob “computes anger.” And every time you experience an emotion, your corresponding blob of neurons supposedly leaps into action, triggering your face and body to respond in a consistent way. Your Fear blob makes you freeze with widened eyes. Your Anger blob makes you scowl and your heart speed up. And so on.

The thing is, this science of “blob-ology” is no more realistic than detonating test tubes and hovering coyotes. Today’s neuroscientists finally have the technology to peer into a living brain without harming its owner, and it’s clear that the brain doesn’t operate even remotely in this cartoonish fashion. We might perceive Joy, Fear and Anger as separate entities — even gloriously rendered in 32-bit color — but the evidence from neuroscience is overwhelmingly against it.

For example, my lab has analyzed nearly 100 published brain-imaging studies by other scientists, involving nearly 1,300 test subjects across 15 years, and found that no brain region is the home for any single emotion. (We do have brain circuits for behaviors like freezing and fighting, as do other animals, but not for complex mental states like fear and anger.)

In another analysis covering 22,000 test subjects across more than 200 studies over 20 years, we demonstrated that anger, happiness, sadness and other emotions don’t have consistent responses in the body either. And plenty of studies have shown that human facial expressions have tremendous variety, far more than would occur if they were automatically launched by “emotion blobs” in the brain. Continue reading

What If Your Doctor Really Listened Instead Of Just Telling You What To Do?

(Alex Proimos/Flickr)

(Alex Proimos/Flickr)

On many a Friday, Dr. Joji Suzuki goes trawling through the medical wards of Brigham and Women’s Hospital with trainees in tow, looking for smokers.

One recent Friday, he finds Thrasher West, a patient who’d had trouble breathing but now is about to go home, where a tempting half-a-pack of cigarettes awaits her.

Dragging in the smoke, blowing it out — smoking feels good to her, West tells Suzuki. But then, she thinks, “Damn. Why’d I do that? Because it’s not good for me –” (Here, her deep cough adds emphasis.) “It’s bad for my health…Aw, I’ll give it up when I finish the pack.”

Suzuki, the hospital’s director of addiction psychiatry, does not lecture her about the risks of smoking. He does not suggest nicotine patches or pills or any other aids for quitting. He just mostly listens, and thoughtfully echoes what she says, and draws her out — when, for example, she mentions that she once quit for five years.

Dr. Joji Suzuki (Courtesy)

Dr. Joji Suzuki (Courtesy)

“Something happened, and you made a decision to stop,” he probes.

Her sons begged her, West recalls. One said, “Mommy, please stop smoking, please stop smoking.”

“Pleading with you…” Suzuki reflects.

“He had tears in his eyes. And he’s my baby, that’s my baby boy.” She reassured her son that she would be around for a long time, she remembers, and he answered, “You keep smoking, no, you won’t!”

Suzuki interprets: “They love their mama so much, they don’t want to lose her.”

The conversation, lasting just a few minutes, may sound like a simple chat. But Suzuki is expertly following principles that have been hammered out over decades and studied in copious research. He listens — actively, empathetically — more than he talks. His comments and questions remind West of her reasons to quit, and bolster her confidence that she can do it. They tap into her values and goals — her love for her family, her desire to live.

By the end, West says she wants badly to stop smoking, and she urgently asks Suzuki to write her a prescription for nicotine patches.

She has just experienced the subtle power of a method that’s increasingly popular in medicine: It’s called motivational interviewing, often referred to just by its initials, MI.

“The big shift in the practice of MI for most practitioners is that you go from telling patients why they should change or how they could change to drawing out from the patient their own ideas about why change would be beneficial to them and about how they might be able to do it,” says Dr. Allan Zuckoff of The University of Pittsburgh, a national leader in the field and author of a new self-guided book, “Finding Your Way to Change: How the Power of Motivational Interviewing Can Reveal What You Want and Help You Get There.”

Click to enlarge. (Courtesy Chang Jun Kim, of the Motivational Interviewing Network of Trainers)

Click to enlarge. (Courtesy Chang Jun Kim, of the Motivational Interviewing Network of Trainers)

Motivational interviewing goes back decades in the field of addiction counseling, Zuckoff says, but in medicine, it’s been really taking off in the last few years.

Hundreds of studies have been published on using it in health care, from diabetes control to reducing the risk of heart disease. It’s being tried for patients with incontinence, psoriasis, hepatitis C, Parkinson’s — virtually any disease in which the patient’s behavior — taking medication, choosing food — affects the outcome. And of course, it can be used for the lifestyle issues that are the biggest driver of American chronic illness: overeating, smoking and drinking and drugs, lack of exercise.

Continue reading

When My Mother Died: A Story Of ‘Incomplete Mourning’

By Sarah Baker

I was 8 years old and the sky was black the day my mother died.

That morning, after a five-year struggle with a brain tumor, she’d passed away at Bethesda Naval Hospital, where she had been admitted a couple of days earlier. I hadn’t seen her since.

Grieving wasn’t an option in our house. We were a “chin up, shoulders back” group led by Dad, a rising star in the Navy. At my mother’s graveside in Arlington National Cemetery, my 10-year-old brother and I stood like little replicas of John F. Kennedy Jr. 12 years earlier when he saluted his father’s coffin. There were no tears, no signs of weakness. Long periods of mourning or sadness were not in our family culture — our grief was put on hold. There were bags to pack, and new ports of call. I was Soldiering On.

The Hardest Thing

According to the advocacy group SLAP’D (Surviving Life After a Parent Dies), 1 in 9 Americans loses a parent before age 20. Of those, nearly half said it was difficult to talk about their grief and only 7 percent said a guidance counselor helped. Six out of 10 adults interviewed, who lost a parent when they were children, said it’s the hardest thing they’ve had to deal with.

Sarah Baker at age 6, two years before her mother died (Courtesy)

Sarah Baker at age 6, two years before her mother died (Courtesy)

For us, the coping mechanism of Soldiering On worked splendidly for years, even decades. I survived all of the moves due to Dad’s deployments, even thrived, people might say. I went to college, graduate school, found great jobs, married a wonderful man, and had two beautiful children. All seemed well, at least on the surface.

But years of anxiety and disassociation gripped me. Recently, though, I felt all that emotional baggage was not sustainable. My external world appeared blissful (and it was!) but my internal world reeled. I had periods of blankness, inability to focus, sleeplessness, feelings of isolation when I was surrounded by loving people; despair, longing for something else, numbness, repeating negative loops in my mind, and sensations of being half dead. These feelings came in waves — days of it followed by lightness and connection. The longest darkness lasted three months — the world drained of its colors and none of my usual “reset,” or coping, tools seemed to work.

Necessary Grief

Importantly, coping is not grieving. “There is a kind of sanity to grief,” says Kay Jamison, a professor of psychiatry at the Johns Hopkins School of Medicine and author of “An Unquiet Mind.” “It provides a path — albeit a broken one — by which those who grieve can find their way. Grief is not a disease; it is a necessity.”

Funerals and other rituals bring people together and defend against loneliness. But if the grief lingers too long, is too severe, or unprocessed, it might begin to resemble depression. It’s a fine line indeed.

I now know I had never fully experienced the pain and sorrow of my grief. Continue reading

The Checkup: How To Feed Your Muffin Top, And Other Weight Loss Wisdom

If you’ve ever hated your weight or wished to trade in a specific body part, or yearned to step off the debilitating dieting roller-coaster, you are so not alone. Indeed, you are us.

So here, we vent about our personal challenges — how to finally lose that last 10 pounds, escaping from our self-imposed food prisons — and explore some new strategies for relief. It’s all in the latest installment of our podcast, The Checkup, a joint venture between WBUR and Slate. We call this episode “Muffin Top,” Download it here before your next meal.

•First, we explore Motivational Interviewing, an increasingly popular technique that can spur you toward making changes in your eating and other behaviors. Included: A new book with the subtitle: “How the Power of Motivational Interviewing Can Reveal What You Want and Help You Get There.”

•We ask an eating disorders expert about why diets don’t work and whether we’ve entered a post-Weight Watchers era.

•And we also also get intimate about the psychic costs of actually achieving your goal weight and trying, desperately, to maintain it.

In case you missed other recent episodes: “Teenage Zombies,” explored the curious minds of adolescents, with segments on sleep, porn and impulsive choices; “Power to the Patient” looked at ways we can all feel in more control of our health care; “High Anxiety” included reports on hormones, parenting and fear of flying; and “Sexual Reality Checks” examined penis size, female desire and aging.

Better yet, don’t miss a single episode and just subscribe now.

Each week, The Checkup features a different topic — previous episodes focused on college mental health, sex problems, the Insanity workout and vaccine issues.

If you listen and like it, won’t you please let our podcasting partner, Slate, know? You can email them at