Vitamin D Intake During Pregnancy May Protect Against ADHD in Children

A new study has found that children of mothers who took Vitamin D while pregnant have fewer symptoms of attention deficit hyperactivity disorder (ADHD) at the age of 2.5.

“For every 10 nmol/L increase in the Vitamin D concentration in umbilical blood, the risk of a being among the 10 percent highest score on the ADHD symptom scale fell by 11 percent,” said Professor Niels Bilenberg of the University of Southern Denmark.

For the study, researchers monitored 1,233 children in the Odense Municipality in Denmark. Vitamin D was measured in the umbilical blood, and mothers completed the Child Behavior Checklist (CBCL) when their child was 2.5 years old. The CBCL questionnaire can be used to identify early symptoms of ADHD, even though an ADHD diagnosis cannot be made at that age, researchers explained.

“The trend was clear: Those mothers who had taken Vitamin D, and had a Vitamin D level (25OHD) in their umbilical blood over 25 nmol/L, had children with lower ADHD scores,” Bilenberg said. “This was after we had corrected for other factors that could explain the link, such as the mother’s age, smoking, alcohol, obesity, education, number of children, psychiatric disease in the parents, child’s sex, age and seasonal variation.”

“We were very surprised that the link was so clear, as there was no previous awareness that this link could be identified at such an early age,” add two of the study’s other authors, medical students Jens Bull Aaby and Mats Mossin.

“It’s impossible to say which children will develop ADHD later on, but it will be interesting to further follow up those children who were at the highest end versus the normal range of the ADHD scale.”

The study offers no explanation as to how Vitamin D can protect against ADHD, but other studies have shown that Vitamin D plays an important role in the early development of the brain, the researchers pointed out.

“We had an idea about it, but we cannot say with certainty that Vitamin D protects against early symptoms of ADHD,” Aaby said. “Our study only indicates that there is a link that we cannot explain in any other way.”

The study was published in The Australia & New Zealand Journal of Psychiatry.

Source: University of Southern Denmark

Body Image Issues May Begin in Preschool

New research suggests young children develop body image much earlier than parents believe.

Parents therefore, often miss opportunities to promote positive body-image formation in their children.

University of Illinois eating disorders and body-image expert Janet Liechty, who led the study, said young children are forming their body images — positive or negative — far earlier than many parents expect and largely outside of parental awareness.

“Parents view early childhood as the ‘age of innocence,’ a time when children are free from body-image awareness or self-consciousness,” said Liechty, a professor of social work and of medicine at Illinois.

“However, aspects of body-related self-concept such as healthy sexuality, body confidence, body acceptance, and early signs of body size preference are all influenced by family socialization processes beginning as early as preschool.”

While parents anticipate peer pressures and body comparisons when their children reach school age or adolescence, they may not recognize that their preschoolers are already exhibiting these behaviors or mimicking their parents’ attitudes about size or weight, Liechty said.

Liechty and her co-authors interviewed 30 parents — 29 mothers and one father — to explore parental perceptions of body image in preschoolers. Each of the parents was the primary caregiver for their children, who ranged in age from just over two to nearly four years.

While a majority of the parents said they did nothing to influence their children’s body image, the communication patterns they described to the research team revealed that they were conveying messages about body image routinely, albeit unconsciously.

Despite most of the parents’ beliefs that their preschoolers were too young to be concerned about body image, 40 percent of the parents described their child exhibiting at least one body-related behavior. Behaviors include children discussing weight, imitating comments about size or weight, or seeking praise for their appearance or clothing,

“Without greater awareness, parents may be missing opportunities to foster body confidence and acceptance in the early years so that kids are better protected from negative body image in adolescence,” said co-author Julie Birky, M.S.W., a clinical counselor with the campus Counseling Center and an adjunct faculty member in the School of Social Work.

“As a parent of preschoolers, it was empowering for me to realize that body image is being formed in these early years and to know that I can create a positive environment in my home to help my sons develop positive body image.”

Parents may be consciously and unconsciously rebelling from social pressures. The researchers hypothesized that parents’ rejection of the notion that preschoolers have body images may represent a protective rejection of the early sexualization of girls and the objectification of bodies that are prevalent in U.S. society.

These parents also may be — wisely — shifting their children’s focus away from their weight or shape as the basis for self-esteem, the researchers suggested.

While frequent commentary about children’s physical appearance has been shown to be detrimental, and families should refrain from teasing or criticizing children about their appearance, avoiding discussions of body image altogether is not likely to be helpful either, Liechty said.

“This approach is reactive, rather than proactive — anticipating dealing with body image only if it becomes a problem,” Liechty said.

“This belief also may cause parents to miss opportunities to create a positive body-image climate within the family and foster resilience by reinforcing their child’s confidence in their physical capacities — which is an important dimension of positive body image.”

Emphasizing and affirming what children can do, rather than focusing on their body appearance or weight, has been associated with better body image among adolescents, according to at least one study.

Liechty added that strategies such as constantly telling a daughter she’s beautiful or cuter than other children, as some parents in the study reported, may have the opposite of the intended effect — increasing a child’s dissatisfaction with their body, priming the child to focus on external validation and promoting an unhealthy preoccupation with attractiveness.

The researchers suggest that a first step toward helping children develop positive body image may be teaching parents how to cultivate it within themselves — by focusing on what their body can do rather than how it looks, by learning to appreciate their body and fostering compassion for themselves when negative body thoughts occur.

Dr. Kristen Harrison, a professor of communication studies at the University of Michigan, and University of Illinois social work graduate student Samantha Clarke were co-authors on the paper.

The study appears online in the journal Body Image.

Source: University of Illinois

Like Boys, Girls with ADHD at Risk for Other Mental Disorders

A new study from the University of California, Los Angeles suggests girls with attention-deficit hyperactivity disorder are at higher risk than girls without ADHD for multiple mental disorders.

Researchers said that for girls, mental issues may lead to cascading problems such as abusive relationships, teenage pregnancies, poor grades, and drug abuse.

According to the federal Centers for Disease Control and Prevention, boys are more than twice as likely to be diagnosed with ADHD than girls; they also are at greater risk of co-occurring mental disorders.

The study by University of California, Los Angeles psychologists was said to be the most comprehensive analysis of girls and ADHD that has ever been undertaken. They discovered:

• 37.7 percent of girls with ADHD met criteria for an anxiety disorder, compared with only 13.9 percent of girls without ADHD;
• 10.3 percent of girls with ADHD were diagnosed with depression compared with only 2.9 percent without ADHD;
• 42 percent of girls with ADHD were diagnosed with oppositional defiant disorder, compared with just five percent of girls without it. Oppositional defiant disorder is characterized by angry, hostile, irritable, defiant behavior. To meet the diagnosis for oppositional defiant disorder, a child must display at least four of eight symptoms for at least six months that result in significant academic, social, and family problems;
• 12.8 percent of girls with ADHD were diagnosed with conduct disorder compared with only 0.8 percent without ADHD. Conduct disorder is similar to oppositional defiant disorder, but with more severe behavioral problems, such as committing violent acts, setting fires, and hurting animals.

The findings appear in the journal Pediatrics.

“We knew the girls with ADHD would have more problems than the girls without ADHD, but we were surprised that conduct disorder and oppositional defiant disorder were at the top of the list, not depression or anxiety,” said Steve Lee, senior author of the study.

“These conduct disorders, more than anxiety and depression, predict severe adult impairments, such as risky sexual behavior, abusive relationships, drug abuse, and crime.”

Symptoms of ADHD include being easily distracted, fidgeting, being unable to complete a single task and being easily bored. The disorder occurs in approximately five percent to 10 percent of children in the United States, and figures in many other industrialized countries with compulsory education are comparable, Lee said.

ADHD can begin in pre-school kids and can persist into high school and into adulthood, especially when it’s accompanied by oppositional conduct disorder.

The psychologists analyzed 18 studies of 1,997 girls, about 40 percent (796) of whom had ADHD. Most of the girls were between ages eight and 13. Most ADHD studies focused on boys, or compared girls with ADHD to boys with ADHD, not to girls without ADHD.

ADHD is often harder to detect in girls than in boys because girls with the disorder may appear disengaged, forgetful, or disorganized, and perceived as “spacey” and stay “under the radar” without being referred for assessment and treatment, said lead author Irene Tung.

Investigators suggest a variety of actions for concerned parents.

First, if a child’s negative behavior lasts for months and is adversely affecting her or his social relationships and school performance, then it’s worth having your child evaluated by a psychologist or psychiatrist for ADHD and other mental disorders.

Furthermore, parents of girls with ADHD should carefully monitor signs of disruptive behavior, anxiety and depression, Tung said. “Early management of ADHD and related symptoms will be critical in helping young girls function successfully at school and socially, and feel confident,” she said.

“People tend to think of girls as having higher risk for depression and anxiety disorders, and boys as being more likely to exhibit conduct disorders, but we found that ADHD for girls substantially increases their risk for these conduct disorders,” Tung said.

Researchers say school systems are prepared to help. “In many cases, the school can provide support, including an evaluation by a school psychologist.”

Approximately five to seven percent of elementary school students have oppositional defiant disorder and approximately one to two percent of elementary school students have conduct disorder, Lee said. Fewer girls than boys have these disorders.

The good news, the psychologists said, is that there are effective treatments — some involving pharmaceuticals, and others that involve seeing a therapist, as well as effective parenting strategies to manage the behavior.

“Kids with ADHD need structure and consistency, more than the average child; they need to know the rules and the rules need to be applied consistently,” Lee said.

Lee and Tung recommend that parents provide positive reinforcement for good behavior; this does not have to be monetary. “For some of these kids, getting negative attention may be their only way of getting attention,” Tung said.

“Catch your child being good, and reward that,” Lee said. Children will sometimes react negatively to rewards in the beginning, and parents at that point will often stop, but should continue, he added. “The child’s behavior will often get worse before it gets better.”

Many more children meet the criteria for ADHD than are being treated for it, and many children may benefit from treatment who are not receiving it, Lee said.

Source: University of California, Los Angeles

Child Duties Tend to Burden Moms, But Are Fun for Dads

A new study using time diary data suggests that although moms enjoy being with their kids, they are less happy than fathers with parenting duties.

The research team from Cornell University, the University of Minnesota, and Minnesota Population Center discovered mothers report more stress and greater fatigue than fathers.

This experience gap is attributed to the differing tasks of each parent. The paper appears in the American Sociological Review.

“The good news from our study is that parents generally enjoy being with their kids,” said University of Minnesota researcher Ann Meier, Ph.D., “but the bad news is that mothers enjoy it less than fathers because they do more of the ‘work’ and less of the ‘fun’ parenting tasks.”

Meier and her colleagues Drs. Kelly Musick at Cornell University and Sarah Flood at the Minnesota Population Center used time diary data from more than 12,000 parents that linked to their feelings in the 2010, 2012, and 2013 American Time Use Survey.

The team examined the types of parenting activities mothers and fathers performed and individual well-being during the activities.

The researchers found that not only do parenting activities between mothers and fathers differ, the environment surrounding the activity differs as well. Meier explained, “when mothers are with their kids, they are more often by themselves.

“When fathers are with their kids, they are more likely to have other adults around, offering some back-up. This helps us understand why fathers are less stressed when with kids.”

Sleep also had an effect on parents’ differing levels of happiness, said Meier.

“Mothers are more likely than fathers to be called on by kids ‘around the clock.’ Fathers’ sleep and down-time are less likely than mothers’ to be interrupted by kids. This is part of the reason fathers are less tired than mothers when parenting.”

Experts say the new paper confirms what many mothers have noted anecdotally. Researchers hope the new information about parenting, activities, and happiness may help close the experience gap between genders.

Meier said, “Having data systematically collected from thousands of parents allows us to confirm what parents have known for years — that parenting is meaningful but also stressful and tiring. Many mothers will recognize their experiences of interrupted sleep and daily feeding and bathing.

“Hopefully, many dads will see that their partners will likely be happier if they trade some of their leisure time with kids for more of the ‘work’ of parenting.”

Source: University of Minnesota

New Data Shows Parents’ Age May Influence Risk of Autism, Not Schizophrenia

The debate as to whether children of older parents have a higher risk for autism or schizophrenia has been going on for more than 3o years, and a new study from Denmark adds relevant and rigorous data to the question.

Prior studies have produced mixed findings as the research has been highly variable. Often, the public health studies are incomparable due to substantial differences in study design.

To address the differences in study design and population characteristics, researchers from the Copenhagen Centre for Social Evolution analyzed a single population sample from the comprehensive Denmark national data set. Investigators used the massive sample to compare risks based on maternal and paternal age, and parental age difference.

Their analysis suggests parents who reproduce later in life are more likely to have children who develop autism disorders. Having children later in life was not, however, associated with increased risk for schizophrenia in offspring.

The research appears in the journal Evolution, Medicine, and Public Health.

The authors used a sample of about 1.7 million Danish people born between January 1978 and January 2009, out of which approximately 6.5 percent were diagnosed with autistic or schizophrenic disorders during this time.

Their data included the full spectrum of nation-wide autistic and schizophrenic diagnoses for up to 30 years of age and over twenty potentially confounding medical and socio-economic factors that they could statistically control for.

Unique personal identification numbers were used to link individuals’ information between different Danish health registries, including the National Patient Registry (holding nationwide hospital admissions since 1977) and the Psychiatric Central Register (with diagnoses for all inpatient admissions since 1969). Combining these data sets also provided the ages of parents when children were born.

Above-average paternal and maternal ages were associated with increased risk of most autistic disorders in offspring and this effect was magnified in offspring of very old fathers. However, advanced maternal and paternal ages were not associated with higher risk of any schizophrenic disorder.

In contrast, children of young parents had reduced risks of autism and only children of very young mothers had increased risks of schizophrenia.

More dissimilarly aged parents meant enhanced risk for both autistic and schizophrenic disorders in offspring compared to parents with similar ages at childbirth, but only up to a certain point where risks leveled out.

For example, higher risk for autism in offspring of older fathers (or mothers) would tend to be compensated if they had a child with a much younger partner.

According to Dr. Sean Byars, the first author of the study,”The magnitude of these increases and decreases in statistical risk need to be scaled against the fortunately rather modest absolute risks of being diagnosed with a mental disorder in Denmark, which is 3.7 percent for all autistic disorders and 2.8 percent for all schizophrenic disorders up to 30 years of age.

“The highest increases and decreases that we could relate to paternal and maternal age added only 0.2-1.8 percent to these absolute risks, but represented changes in relative risk of 76-104 percent.”

The study also discusses why these risk patterns continue to exist in modern humans and suggests that they are remnants of our evolutionary past.

In an earlier study of the same population the authors showed that autism risks are associated with above average sizes at birth and schizophrenia risks with smaller (but) still normal sizes at birth. The authors highlight that modern families of 1-3 children now typically originate at ages that our ancestors were completing families of 6-8 children provided these children survived.

“Natural selection has shaped how parents, and particularly mothers, allocated their reproductive investments best in the face of uncertain conditions during our prehistory and well into modern historical times,” said Professor Jacobus Boomsma, the senior author of the study.

“It was not very long ago that most mothers had their first child around the age of 20 and went through 10 pregnancies. Our modern reproductive patterns are thus a poor match to what humans are likely to be naturally adapted to. Our evolutionary interpretations suggest how we can possibly understand recently increased mental disease risks that have no direct medical explanation.”

Source: Oxford University Press/EurekAlert

Most Western Parents Outdo Their Own Parents in Time Spent With Kids

New research should help guilt-ridden moms and dads feel better about the time they are spending with their children.

Investigators from University of California, Irvine discovered mothers and fathers across most Western countries are spending more time with their children than parents did in the mid-’60s. And time spent with kids is highest among better-educated parents — a finding that somewhat surprised study co-author Dr. Judith Treas, University of California, Irvine Chancellor’s Professor of sociology.

“According to economic theory, higher wages should discourage well-educated parents from foregoing work to spend extra time with youngsters,” she said. “Also, they have the money to pay others to care for their children.”

Treas and co-author Dr. Giulia M. Dotti Sani, a postdoctoral fellow at Collegio Carlo Alberto in Turin, Italy, found that between 1965 and 2012, all but one of 11 Western nations showed an increase in the amount of time both parents spent with their kids.

The study appears online in the Journal of Marriage and Family.

In 1965, mothers spent a daily average of 54 minutes on child care activities, while moms in 2012 averaged almost twice that at 104 minutes per day. Fathers’ time with children nearly quadrupled — 1965 dads spent a daily average of just 16 minutes with their kids, while today’s fathers spend about 59 minutes a day caring for them.

These numbers include parents from all education levels. When the researchers broke out the 2012 data into two categories — parents with a college education versus parents without — they found quite a difference.

College-educated moms spent an estimated 123 minutes daily on child care, compared with 94 minutes spent by less educated mothers. Fathers with a college degree spent about 74 minutes a day with their kids, while less educated dads averaged 50 minutes.

Study findings were based on the Multinational Time Use Study Harmonized Simple Files, which focused on parents between the ages of 18 and 65 living in households with at least one child under the age of 13.

From 1965 to 2012, the 122,271 parents (68,532 mothers, 53,739 fathers) in Canada, the U.K, the U.S., Denmark, Norway, France, Germany, the Netherlands, Italy, Spain, and Slovenia were asked to keep a diary of all their daily activities.

Researchers then analyzed differences by randomly selecting one day from each diary and tabulating the amount of time recorded for both interactive and routine child care activities.

“Time spent with children involved everything from preparing their meals and snacks to feeding and bathing them, changing diapers and clothes, putting them to bed, getting up in the middle of the night, unpaid babysitting, providing medical care, reading and playing with them, as well as supervising and helping with homework,” Treas said.

France was the only country that showed a decrease in mothers’ child care time. The decline was not as steep for college-educated moms as it was for less educated French mothers, while for dads, both education levels saw an increase in parenting time.

According to Treas, the study results — aside from France — are in line with an “intensive parenting” ideology that has become a cultural child rearing trend.

“The time parents spend with children is regarded as critical for positive cognitive, behavioral, and academic outcomes,” she said. “Contemporary fathers — having more egalitarian gender views — want to be more involved in their children’s lives than their own dads were. These beliefs have taken hold among the best-educated residents of Western countries and are also diffusing to their counterparts who have less schooling.”

As for the difference in France, Treas said, “No one is certain why the French are exceptional. Public spending on child care is fairly high in France, lightening parental responsibilities. Some experts speculate that the French simply believe children can accommodate successfully without parents making big changes to their lifestyles.”

Source: University of California, Irvine

Young Adults’ Odds of Prescription Opioid Abuse Doubled in a Decade

Young adults are twice as likely to have a prescription opioid use disorder compared to a decade ago, according to researchers at Columbia University’s Mailman School of Public Health.

The study, published online in the journal Addictive Behaviors, is the first to investigate time trends and increases over the last decade (2002 to 2014) in prescription opioid use disorder, defined as meeting the criteria for DSM (clinical) abuse and dependence and needing treatment.

Study participants included adolescents (12 to 17 years), emerging adults (18 to 25 years), and young adults (26 to 34 years) who used prescription opioids for nonmedical purposes.

Emerging adults had a 37 percent increase in the odds of having prescription opioid use disorder, and young adults doubled their odds from 11 percent to 24 percent. Among adolescents, the prevalence of prescription opioid use disorder remained relatively stable during the same period.

Data originated from the 2002 to 2014 National Survey on Drug Use and Health.

“While increases in prescription opioid use disorder might be rooted in health policy, medical practice, pharmaceutical industry interests, and patient behavior, it is critical that the general public, particularly youth, are informed about the related harms and disorders that can occur when prescription opioids are used without regular medical supervision,” said first author Silvia Martins, M.D., Ph.D., associate professor of epidemiology.

The researchers also found a four-fold and nine-fold increase over time in the odds of heroin use among emerging adults and young adults who had used opioids without a medical prescription, respectively.

“We see an increasing trend from 2002 to 2014 among both groups,” said Martins.

The odds of past-year heroin use among emerging adults rose from two percent to seven percent, and from two percent to 12 percent among young adults. Nearly 80 percent of 12- to 21-year-olds who reported initiation of heroin use had previously started using prescription opioids between the ages of 13 and 18.

“Given this and the high probability of nonmedical use among adolescents and young adults in general, the potential development of prescription opioid use disorder among youth and young adults represents an important and growing public health concern,” said Martins.

“Our analyses present the evidence to raise awareness and urgency to address these rising and problematic trends among young adults,” said Martins.

Source: Columbia University Medical Center