Persons displaced by war at increased risk of posttraumatic stress disorder, depression, anxiety

ScienceDaily (Aug. 3, 2011) — Residents of Sri Lanka who were internally displaced during the civil conflict that occurred in their country from 1983 to 2009 have a higher prevalence of war-related mental health conditions that include depression, anxiety and posttraumatic stress disorder, according to a study in the August 3 issue of JAMA, a theme issue on violence and human rights.

Armed conflicts may result in displacement of persons seeking refuge in neighboring countries or secure areas of their own country (internal displacement). "Nearly 2.7 million individuals worldwide are internally displaced annually by armed conflict. The Sri Lankan conflict resulted in approximately 100,000 deaths and displacement of 800,000 people during the 26-year war," according to background information in the article. In the Jaffna District of Sri Lanka, a peninsula in the far north of the country, it has been estimated that 23 percent of the population had been internally displaced by July 2009. "Although overall patterns of psychiatric morbidity among conflict-affected populations have been documented, less is known about the psychological effect of forced displacement among individuals who remain within their national borders."

Farah Husain, D.M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted a health survey among residents of Jaffna District to assess the association between displacement status and the prevalence of common war-related mental health conditions. The survey was conducted between July and September 2009 among 1,517 Jaffna District households, including 2 internally displaced persons camps. The response rate was 92 percent (1,448 respondents, 1,409 eligible respondents). Two percent of participants (n = 80) were currently displaced, 29.5 percent (n = 539) were recently resettled, and 68.5 percent (n = 790) were long-term residents. A total of 376 (31.8 percent) participants experienced no trauma events; 578 (44.0 percent) reported experiencing 1 to 4 events; 336 (20.2 percent) experienced 5 to 9 events; and 72 (4.0 percent) experienced 10 or more events.

The overall prevalences of posttraumatic stress disorder (PTSD), anxiety, and depression symptoms were 7.0 percent, 32.6 percent, and 22.2 percent, respectively. After adjusting for variables, the researchers found that the odds of having symptoms of depression, anxiety, and PTSD were significantly higher among displaced camp-based individuals compared with long-term residents and that the odds of reporting PTSD symptoms among recently resettled participants was higher than that of long-term residents. Female respondents were more likely to report symptoms of anxiety and depression. Older age was associated with PTSD, anxiety, and depression symptoms. The authors also found that displacement was no longer associated with mental health symptoms after controlling for trauma exposure.

"Although the association between displacement status and symptoms of PTSD, depression, and anxiety was no longer significant after adjusting for trauma exposure in this study, the act of being displaced and the daily stressors associated with it may be considered traumatic in themselves and may be an indicator or proxy for recent trauma as well. Therefore, the relationship between displacement status and mental health symptoms may be driven by the underlying trauma events displaced persons have experienced, events that likely caused them to leave their homes," they write.

The researchers suggest that interventions in Sri Lanka should target the most vulnerable populations, especially those living in displacement camps. "Internally displaced persons outnumber refugees globally and initiatives addressing mental health needs, such as those developed by the Inter-Agency Standing Committee, should be considered. In Jaffna District, interventions should include support from family, friends, religious leaders, and traditional counselors. Finally, a longitudinal study of displaced populations would help determine how the intensity of events, the time since events, and other factors, such as coping skills, affect mental health symptoms. In this way, stakeholders could begin to understand the short- and long-term mental health implications of armed conflict and traumatic events associated with displacement."

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal Reference:

F. Husain, M. Anderson, B. Lopes Cardozo, K. Becknell, C. Blanton, D. Araki, E. Kottegoda Vithana. Prevalence of War-Related Mental Health Conditions and Association With Displacement Status in Postwar Jaffna District, Sri Lanka. JAMA: The Journal of the American Medical Association, 2011; 306 (5): 522 DOI: 10.1001/jama.2011.1052

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Sexual anxiety, personality predictors of infidelity, study says

ScienceDaily (July 25, 2011) — People with sexual performance anxiety are more likely to cheat on their partners. That's just one of the curious findings of a new study by a University of Guelph professor on the factors that predict infidelity.

Men who are risk-takers or easily sexually aroused are also more likely to wander; for women, relationship issues are stronger predictors of unfaithfulness.

The study, published recently in the journal Archives of Sexual Behaviour, is the first to look at how demographics, interpersonal factors and sexual personality affect infidelity.

For both men and women, personality characteristics and interpersonal factors are more relevant predictors than are religion, marital status, education or gender.

"Few studies on infidelity have gone beyond exploring demographics," said Robin Milhausen, a professor and sexuality researcher in Guelph's Department of Family Relations and Applied Nutrition who conducted the study with Kristen Mark and Erick Janssen of Indiana University.

"This research shows that demographic variables may not influence decision-making as much as previously thought -- that personality matters more, especially for men."

The study involved 506 men and 412 women who reported being in monogamous sexual relationships lasting from three months to 43 years. Participants were asked to report on demographic variables such as religion, education and income. They also completed scales that measured sexual personality variables and answered questions about their relationships.

The study found little difference in rates of infidelity reported by men and women (23 and 19 per cent, respectively). But different things predicted the behavior for men and women.

For men, significant predictors of infidelity are personality variables, including propensity for sexual excitation (becoming easily aroused by many triggers and situations) and concern about sexual performance failure.

The latter finding might seem counterintuitive, Milhausen said, but other studies have also found this connection. "People might seek out high-risk situations to help them become aroused, or they might choose to have sex with a partner outside of their regular relationship because they feel they have an 'out' if the encounter doesn't go well -- they don't have to see them again."

For women, relationship happiness is paramount. Women who are dissatisfied with their relationship are more than twice as likely to cheat; those who feel they are sexually incompatible with their partners are nearly three times as likely.

"All kinds of things predict infidelity," Milhausen said. "What this study says is that when you put all of those things together, for men, personality characteristics are so strong they bounce everything else out of the model. For women, in the face of all other variables, it's still the relationship that is the most important predictor."

Milhausen cautions against misinterpreting or overemphasizing the study's findings. "Taken at face value, this research might seem to just support sexual stereotypes: Women are just concerned about the relationship, and, for men, once a cheater, always a cheater, regardless of their relationship. But the caveat is that there are a lot of variants and factors that are not explained here that might impact whether someone cheats."

Still, knowing that sexual personality characteristics -- and, for women, relationship factors -- are strong predictors suggests directions for therapeutic interventions, she said.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Guelph.

Journal Reference:

Kristen P. Mark, Erick Janssen, Robin R. Milhausen. Infidelity in Heterosexual Couples: Demographic, Interpersonal, and Personality-Related Predictors of Extradyadic Sex. Archives of Sexual Behavior, 2011; DOI: 10.1007/s10508-011-9771-z

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Omega-3 reduces anxiety and inflammation in healthy students, study suggests

ScienceDaily (July 13, 2011) — A new study gauging the impact of consuming more fish oil showed a marked reduction both in inflammation and, surprisingly, in anxiety among a cohort of healthy young people.

The findings suggest that if young participants can get such improvements from specific dietary supplements, then the elderly and people at high risk for certain diseases might benefit even more.

The findings by a team of researchers at Ohio State University were just published in the journal Brain, Behavior and Immunity. It is the latest from more than three decades of research into links between psychological stress and immunity.

Omega-3 polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have long been considered as positive additives to the diet. Earlier research suggested that the compounds might play a role in reducing the level of cytokines in the body, compounds that promote inflammation, and perhaps even reduce depression.

Psychological stress has repeatedly been shown to increase cytokine production so the researchers wondered if increasing omega-3 might mitigate that process, reducing inflammation.

To test their theory, they turned to a familiar group of research subjects -- medical students. Some of the earliest work these scientists did showed that stress from important medical school tests lowered students' immune status.

"We hypothesized that giving some students omega-3 supplements would decrease their production of proinflammatory cytokines, compared to other students who only received a placebo," explained Janice Kiecolt-Glaser, professor of psychology and psychiatry.

"We thought the omega-3 would reduce the stress-induced increase in cytokines that normally arose from nervousness over the tests."

The team assembled a field of 68 first- and second-year medical students who volunteered for the clinical trial. The students were randomly divided into six groups, all of which were interviewed six times during the study. At each visit, blood samples were drawn from the students who also completed a battery of psychological surveys intended to gauge their levels of stress, anxiety or depression. The students also completed questionnaires about their diets during the previous weeks.

Half the students received omega-3 supplements while the other half were given placebo pills.

"The supplement was probably about four or five times the amount of fish oil you'd get from a daily serving of salmon, for example," explained Martha Belury, professor of human nutrition and co-author in the study.

Part of the study, however, didn't go according to plans.

Changes in the medical curriculum and the distribution of major tests throughout the year, rather than during a tense three-day period as was done in the past, removed much of the stress that medical students had shown in past studies.

"These students were not anxious. They weren't really stressed. They were actually sleeping well throughout this period, so we didn't get the stress effect we had expected," Kiecolt-Glaser said.

But the psychological surveys clearly showed an important change in anxiety among the students: Those receiving the omega-3 showed a 20 percent reduction in anxiety compared to the placebo group.

An analysis of the of the blood samples from the medical students showed similar important results.

"We took measurements of the cytokines in the blood serum, as well as measured the productivity of cells that produced two important cytokines, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFa)," said Ron Glaser, professor of molecular virology, immunology & medical genetics and director of the Institute for Behavioral Medicine Research.

"We saw a 14 percent reduction in the amounts of IL-6 among the students receiving the omega-3." Since the cytokines foster inflammation, "anything we can do to reduce cytokines is a big plus in dealing with the overall health of people at risk for many diseases," he said.

While inflammation is a natural immune response that helps the body heal, it also can play a harmful role in a host of diseases ranging from arthritis to heart disease to cancer.

While the study showed the positive impact omega-3 supplements can play in reducing both anxiety and inflammation, the researchers aren't willing to recommend that the public start adding them to the daily diet.

"It may be too early to recommend a broad use of omega-3 supplements throughout the public, especially considering the cost and the limited supplies of fish needed to supply the oil," Belury said. "People should just consider increasing their omega-3 through their diet."

Some of the researchers, however, acknowledged that they take omega-3 supplements.

Also working on the research with Kiecolt-Glaser, Glaser and Belury were William Malarkey, professor emeritus of internal medicine, and Rebecca Andridge, an assistant professor of public health.

The study was supported in part by a grant from the National Center for Complementary and Alternative Medicine, a part of the National Institutes of Health.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Ohio State University. The original article was written by Earle Holland.

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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