TANNING BEDS...MELANOMA AND OTHER BAD THINGS

In the News Updates section of the May/June edition of the AACAP News a study by Guy, et al. reported in the JAMA Dermatol (epub ahead of print) found that according to the 2009 and 2011 national Youth Risk Behaviors Survey using a representative sample of 15.5 million high school students each year that included 25,000 students who used tanning beds.  

These tanning bed users were more likely to be female, older and non-hispanic white.  Nearly 30% of 18 years of age or older of these students used tanning beds.  Among male and female students, tanning bed use was associated with increased binge drinking, unhealthy weight control practicing and having sexual intercourse.  Just among the female students, tanning bed use was associated with having sexual intercourse with four or more persons and illegal drug use.  Among male tanning bed users, they were more likely to have used steroids, smoked cigarettes daily and to have attempted suicide.  

So, it seems that there might be additional reasons to encourage our teenagers to not use tanning beds, besides the risk of melanomas.  Thus, it is important that we talk to our teenagers about tanning bed use and also that our pediatricians and family care physicians also ask about the use of tanning beds.  Of course, it is also important that we remind our adult children about the risks of tanning bed use.

OBESITY AND GRADES FOR ADOLESCENT GIRLS

The News Update section of the AACAP News from May/June 2014 reported on a study from the United Kingdom that was epublished ahead of print in the International Journal od Obesity (Lond) by Booth, JN et al. The study followed 6,000 adolescents from age 11 to 16.  They assessed their achievement scores in English, math, and science at ages 11, 13, and 16. They controlled for a number of factors including socioeconomic status, IQ, mental health and age of menarche. They found that who were obese at age 11, performed much worse academically than their normal weight peers at age 13 and 16.  The difference was the equivalent of one letter grade and could be enough to keep the obese girls from getting into a college.  The impact on grades was not clear for obese male adolescents.

It has been established that obese children and adolescents are at higher risk for a number of medical problems, including psychiatric disorders.  Now it seems that learning is also compromised. It is encouraging that, as I have previously blogged, the percent of children who are obese is going down.  This may be related to efforts to improve their diets by restricting poor food choices in schools and educating children and their parents about healthy diets. Also, Michelle Obama's "Let's Move" program reinforces healthy food choices and excercising.  All this is helping and the stakes are high considering all the health problems and now,learning problems associated with obesity.  Maybe it is time to have a national (international?) effort to get people to "just say no to fast food."

GUNS DON'T KILL PEOPLE, MENTALLY ILL PEOPLE DO!

Well of course that is only a very small part of killings with guns in the world. It just gets a whole lot more attention from the media.  A recent killing rampage in California by Elliot Rodger has led to more calls for the involuntary comittment of the mentally ill as Elloit's recent and past behavior suggests that he was mentally ill. This is commented upon in an opinion piece in the June 3, 2014 NY Times by Joe Nocera.  Mr. Nocera does not believe that locking up the mentally ill who are agitated and yet not making specific threats to individuals, and who can function independently, is the answer. Mr. Nocera ends his opinion piece wondering if the focus should be on making it harder for anyone to get guns, not just the mentally ill. 

Well, that idea suffers from being too logical and effective in signifantly reducing gun related deaths. It requires that we as a country take responsibility for the suffering and loss that are insistence on the right to arm ourselves has caused. We are now moving toward defining our right to bear arms to include carrying concealed weapons on college campuses (according to the National Conference of State Legislatures website seven states have laws permitting this). I have blogged before about the problem of access to weapons and all the deaths, including children, related to this. As I've mentioned, "guns don't kill people, but people with guns do!"

Getting back to potentially violent people suffering from mental illnesses, I have two points to make. The first one is that Elliot Rodger's parents reported that Elliot was severely bullied as a child. I have blogged a couple of times about the damage that bullying can do and the deadly reactions that can occur, including suicide and homicide. My second point is that it might be time to take seriously general threats made online and in other settings. It seems prudent and reasonable to consider these threats a crime. This could have led to Elloit getting help.  Finally, people who are bullied will sometimes cope by bullying others. Another reason to work to reduce bullying and provide more help for those who are bullied and even for the bullies!

CYBERBULLYING AND SUICIDAL THOUGHTS AND ATTEMPTS

I have previously blogged about the impact of bullying including an increased suicide risk.  There is evidence now that bullying online or via social media is at least as traumatizing as other forms of bullying. A recent study by Van Geel, et al. reported on their meta-analysis of 34 studies involving over 284,000 children.  They found that being bullied [peer victimization] increased the odds ratio for suicidal ideation to 2.23 and for suicide attempts to 2.55.  In their study, cyberbullying was at least as toxic as other forms of bullying.  The odds ratio number represents the odds of having suicidal ideas or actions and having been bullied.  Thus, of the children with suicidal ideas or actions, they were two and a forth to two and a half times as likely to have been bullied.  This is one way of determining the link between being bullied and developing suicidal ideas or suicidal actions.  

It seems clear that cyberbullying is both traumatic for children and adolescents and significantly increases the risk of suicidal behavior.  It is important for mental health professionals to always ask about bullying, including cyberbullying.  It is also important for parents to be aware of what types of experiences their children and adolescents are having on the internet and social media as well as what they are experiencing at school.  Parents must risk being considered intrusive and controlling since their children or adolescents lives might depend on them being this way.

BUDDHA'S BRAIN

I recently listened to a lecture presented at Google by Rick Hanson, the author with Daniel Seigel of Buddha's Brain. I am also now reading the book.  The lecture focused on the reality of our brains being highly reactive to percieved threats and that this keeps us feeling stressed, compromises our immune sytems and leads to unhappiness and misery.  He calls this  "threat reactivity." He notes that it is important to be able to react rapidly to a real threat and yet we have expanded what we consider real theats and are frequently reacting to life events as if they are real threats to us.  Dr. Hanson calls this "paper tiger paranoia," as we are reacting to paper tigers as if they were real tigers.  This is not only damaging to our brains and reduces our chance to be happy, but also makes it easy for others to manipulate us by their promoting the "us vs them" mentality and validating our paranoia.  We are encouraged to feel threatened and to focus our paranoia on a certain group of people.  This is how good people can be manipulated to do bad things and often prejudice, oppression of others and wars are the outcome. 

Well that seems bad.  So, what can we do?  Dr. Hanson states that when we use our minds, we change our brains.  He calls this neuroplasticity since our brains change based on how we use our minds. Therefore, if we can change the way we use our minds to be more focused on positive things and allow ourselves to see and feel the positive, we will be able to diminish our threat reactivity type behaviors. Dr. Hanson believes that learning "mindful self-awareness" is a good way to be more positive in our reactions to people and events.  This type of self-awareness is often spoken of as "mindfulness" or "mindfulness practice." I would recommend that you check this out via the internet or by speaking to someone who is familiar with it. Then, you might decide to learn about it and start using it.