Tag: SMU Department of Psychology

A new breathing therapy reduces panic and anxiety by reversing hyperventilation

Post author By Margaret Allen
Post date December 16, 2010

Breakthrough “CART” treatment better than traditional cognitive therapy at altering hyperventilation and panic symptoms

http://www.youtube.com/watch?v=AcQsJnLBWpE

A new treatment program teaches people who suffer from panic disorder how to reduce the terrorizing symptoms by normalizing their breathing.

The method has proved better than traditional cognitive therapy at reducing both symptoms of panic and hyperventilation, according to a new study.

The biological-behavioral treatment program is called Capnometry-Assisted Respiratory Training, or CART, said psychologist and panic disorder expert Alicia E. Meuret at Southern Methodist University in Dallas.

CART helps patients learn to breathe in such a way as to reverse hyperventilation, a highly uncomfortable state where the blood stream operates with abnormally low levels of carbon dioxide, said Meuret, one of the researchers conducting the study.

Hyperventilation, a state of excessive breathing, results from deep or rapid breathing and is common in patients with panic disorders.

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“We found that with CART it’s the therapeutic change in carbon dioxide that changes the panic symptoms — and not vice versa,” Meuret said.

CART: Breathing exercises twice a day
During the treatment, patients undergo simple breathing exercises twice a day. A portable capnometer device supplies feedback during the exercises on a patient’s CO2 levels. The goal of these exercises is to reduce chronic and acute hyperventilation and associated physical symptoms. This is achieved by breathing slower but most importantly more shallowly. Contrary to lay belief, taking deep breaths actually worsens hyperventilation and symptoms.

“Most panic-disorder patients report they are terrified of physical symptoms such as shortness of breath or dizziness,” Meuret said. “In our study, cognitive therapy didn’t change respiratory physiology, but CART did effectively reduce hyperventilation. CART was proved an effective and powerful treatment that reduces the panic by means of normalizing respiratory physiology.”

The findings, “Respiratory and cognitive mediators of treatment change in panic disorder: Evidence for intervention specificity,” appeared in the Journal of Consulting and Clinical Psychology. Meuret, who developed CART, is an assistant professor in the Department of Psychology at SMU and co-directs the department’s Stress, Anxiety and Chronic Disease Research Program. The Beth & Russell Siegelman Foundation funded the research.

CART breathing a proven biological therapy
The study pitted CART against a conventional cognitive therapy treatment, or CT. Traditional CT teaches patients techniques aimed at helping them change and reverse catastrophic thoughts in order to reduce fear and panic.

In the CART-CT study, 41 patients were assigned to complete either a CART or CT treatment program for panic disorder and agoraphobia, a fear of being trapped with no means of escape or help.

Both treatment programs were equally effective in reducing symptoms, said Meuret. But CART was the only treatment to physiologically alter panic symptoms by actively reversing hyperventilation in the patients. Cognitive therapy didn’t change the respiratory physiology, said Meuret.

Treatment helps patients address terror associated with panic
The study is the second randomized control trial to measure CART’s effectiveness. By reversing hyperventilation, patients reported a new ability to reduce panic symptoms by means of changing their respiration.

With CT, Meuret said, if a patient reports shortness of breath, the therapist challenges the assumption by asking how often the person actually has suffocated during a panic attack, then hopes that will reverse the patient’s thinking.

“I found that process very challenging for some of my patients because it acknowledges the symptom but says it’s not a problem,” Meuret said.

“CART, however, tells us a patient’s CO2 is very low and is causing many of the symptoms feared, but it can also show how to change these symptoms through correct breathing. There has been an assumption that if people worry less about symptoms it will also normalize their physiology, but this study shows that this is not the case,” she said. “Hyperventilation remains unchanged, which could be a risk factor for relapse down the road. Apart from hyperventilation being a symptom generator, it is an unhealthy biological state associated with negative health outcomes.”

Broader study planned to measure CART
The researchers plan to branch out with their studies on CART by taking the program into the community, particularly to ethnic minorities. They believe CART is a more universally understood treatment due to its physical exercises — as opposed to cognitive therapy’s more intellectual methods — and therefore more accessible to a broader range of people with varying levels of education and different cultural backgrounds. Ongoing studies will test the efficacy of CART in patients with asthma and fear of blood.

Co-authors of the study at SMU were David Rosenfield, associate psychology professor, and psychology graduate students Anke Seidel and Lavanya Bhaskara. Stefan G. Hofmann, psychology professor at Boston University, was also an author on the paper. The research was funded by the Beth & Russell Siegelman Foundation. — Austin Reed

SMU is a private university in Dallas where nearly 11,000 students benefit from the national opportunities and international reach of SMU’s seven degree-granting schools. For more information see www.smu.edu.

SMU has an uplink facility on campus for live TV, radio or online interviews. To speak with Dr. Meuret or to book an interview with her in the SMU studio, call SMU News & Communications at 214-768-7650.

Tags Alicia E. Meuret, Anke Seidel, David Rosenfield, Lavanya Bhaskara, SMU Department of Psychology

Culture, Society & Family Learning & Education Mind & Brain Plants & Animals

New child development theory bridges nature vs. nurture; parental guidance shapes child’s strengths

Post author By Margaret Allen
Post date December 1, 2010

How a child turns out determined by nature, nurture — and parental guidance shaped by child’s strengths

Why does a child grow up to become a lawyer, a politician, a professional athlete, an environmentalist or a churchgoer?

It’s determined by our inherited genes, say some researchers. Still others say the driving force is our upbringing and the nurturing we get from our parents.

But a new child-development theory bridges those two models, says psychologist George W. Holden at Southern Methodist University in Dallas. Holden’s theory holds that the way a child turns out can be determined in large part by the day-to-day decisions made by the parents who guide that child’s growth.

“This model helps to resolve the nature-nurture debate,” Holden says. “Effective parents are taking nature into account in their nurturing. It’s a slightly different twist.”

Parental guidance is key
Child development researchers largely have ignored the importance of parental “guidance,” Holden says. In his model, effective parents observe, recognize and assess their child’s individual genetic characteristics, then cultivate their child’s strengths.

“It’s been said that parents are the ‘architect’ or the ‘conductor’ of a child’s development. There are lots of different synonyms, but the terms don’t capture the essence that parents are trying to ‘guide,'” Holden says. “Some parents have more refined goals — like wanting their child to be an athlete or to have a particular career. Some have more general goals — such as not wanting their child to become a criminal. But all are positive goals.”

Holden describes and explains his theory and research in the article “Childrearing and Developmental Trajectories: Positive Pathways, Off-ramps, and Dynamic Processes” in the current issue of the journal Child Development Perspectives. The theory is also detailed in his child psychology textbook, “Parenting, A Dynamic Perspective,” published by Sage Publications Inc., 2010.

Parents help or hinder progress
In decades past, researchers have studied many aspects of parenting that Holden describes as “unidimensional” and easier to quantify than guidance. Examples include: how parents reinforce their children’s behavior, punish their children or show them love and warmth.

Only in the last decade have researchers studied the role parents play in helping or hindering their child’s progress toward — or abandonment of — a particular course of development, he says.

“It’s not an easy set of behaviors to observe and quantify because it’s more complex in that it relates to parental goals that they have for their children,” he says. “It’s also multi-faceted. It’s not a simple unitary behavior that can be easily and reliably counted up. So there are methodological reasons it hasn’t been studied, and there are also biases and theoretical orientations that have neglected this.”

The time has come, however, to understand the impact of parental guidance, Holden says. Sophisticated statistical procedures now allow new research techniques such as growth-curve modeling and group-based trajectory analysis. Other child development experts have ventured into the interaction between child and parent trajectories, says Holden. He hopes many more will join in advancing the concept, which he considers critical to understanding child development.

“I’m certainly not the first to think of this, but I’ve framed it a little differently and a little more comprehensively than it’s been discussed before,” Holden says. “I’m sure there are things I haven’t thought of, so hopefully this will generate discussion, research and modification. And I hope it will trickle down to parents so they can see the critical role they can play in helping their children develop in positive ways.”

Pathways or trajectories
In his conceptual framework, Holden hypothesizes that parents guide their children’s development in four complex and dynamic ways:

Parents initiate trajectories, sometimes trying to steer their child in a preferred developmental path based on either the parents’ preferences or their observations of the child’s characteristics and abilities, such as enrolling their child in a class, exposing them to people and places, or taking a child to practices or lessons;
Parents also sustain their child’s progress along trajectories with encouragement and praise, by providing material assistance such as books, equipment or tutoring, and by allocating time to practice or participate in certain activities;
Parents mediate trajectories, which influences how their child perceives and understands a trajectory, and help their child steer clear of negative trajectories by preparing the child to deal with potential problems;
Finally, parents react to child-initiated trajectories.

Trajectories are useful images for thinking about development because one can easily visualize concepts like “detours,” “roadblocks” and “off-ramps,” Holden says. Detours, he says, are transitional events that can redirect a pathway, such as divorce. Roadblocks are events or behavior that shut down a potential trajectory, such as teen pregnancy, which can block an educational path. Off-ramps are exits from a positive trajectory, such as abusing drugs, getting bullied or joining a gang.

Holden says there are other ways parents influence a child’s progress on a trajectory, such as through modeling desired behaviors, or modifying the speed of development by controlling the type and number of experiences.

Some of the ways in which children react to trajectories include accepting, negotiating, resisting or rejecting them, he says.

“Some factors that also can influence trajectories include the family’s culture, their income and family resources, and the quality of the parent-child relationship,” says Holden. “What this model of parenting helps to point out is that effective parenting involves guiding children in such a way as to ensure that they are developing along positive trajectories.”

Holden is a professor in the SMU Department of Psychology. — Margaret Allen

SMU has an uplink facility on campus for live TV, radio or online interviews. To speak with Dr. Holden or to book him in the SMU studio, call SMU News & Communications at 214-768-7650.

Tags George W. Holden, SMU Department of Psychology

Culture, Society & Family Health & Medicine Researcher news SMU In The News

UPI: Abusive mothers can improve parenting

Post author By Margaret Allen
Post date August 6, 2010

UPI covered the research of SMU psychologists Ernest Jouriles, Renee McDonald, David Rosenfield and Deborah Corbitt-Shindler in a July 30 story “Abusive mothers can improve parenting.”

EXCERPT:

DALLAS, July 30 (UPI) — Abusive mothers, who are taught parenting skills and given emotional support, can improve their parenting skills, two U.S. researchers say.

Ernest Jouriles and Renee McDonald of Southern Methodist University in Dallas say parenting improved in impoverished, neglectful, abusive mothers after home visits, classes and emotional support from therapists.

The study, published in the Journal of Family Psychology, says large improvements in mothers’ parenting were observed in families given instruction and emotional support compared to families that did not receive the services.

Jouriles is professor and chairman of the SMU Psychology Department. McDonald and Rosenfield are associate professors. Corbitt-Shindler is a psychology department doctoral candidate.

Read the full story: “Abusive mothers can improve parenting”

Tags David Rosenfield, Deborah Corbitt-Shindler, Dedman College, Ernest Jouriles, Renee McDonald, SMU Department of Psychology, SMU Family Research Center

Culture, Society & Family Learning & Education Mind & Brain

Abusive mothers improve their parenting after home visits, classes and emotional support from therapists

Post author By Margaret Allen
Post date July 26, 2010

Mothers who live in poverty and who have abused their children can stop if they are taught parenting skills and given emotional support.

A new study has found that mothers in families in which there is a history of child abuse and neglect were able to reduce how much they cursed at, yelled at, slapped, spanked, hit or rejected their children after a series of home visits from therapists who taught them parenting skills.

There were large improvements in mothers’ parenting in families that received the intensive services, compared to families that did not receive the services, according to SMU psychologists Ernest Jouriles and Renee McDonald at Southern Methodist University in Dallas, two of the study’s eight authors.

As a result of the intensive, hands-on training, the women in the study said they felt they did a better job managing their children’s behavior, said Jouriles and McDonald. The mothers also were observed to use better parenting strategies, and the families were less likely to be reported again for child abuse.

“Although there are many types of services for addressing child maltreatment, there is very little scientific data about whether the services actually work,” said McDonald. “This study adds to our scientific knowledge and shows that this type of service can actually work.”

Help for violent families
The parenting training is part of a program called Project Support, developed at the Family Research Center at SMU and designed to help children in severely violent families.

The study appears in the current issue of the quarterly Journal of Family Psychology. The article is titled “Improving Parenting in Families Referred for Child Maltreatment: A Randomized Controlled Trial Examining Effects of Project Support.” SMU psychologist David Rosenfield also authored the study.

The research was funded by the federal Interagency Consortium on Violence Against Women and Violence Within the Family, along with the Texas-based Hogg Foundation for Mental Health.

“Child maltreatment is such an important and costly problem in our society that it seems imperative to make sure that our efforts — and the tax dollars that pay for them — are actually solving the problem,” said Jouriles. He and McDonald are co-founders and co-directors of the SMU Family Research Center.

In 2007, U.S. child welfare agencies received more than 3 million reports of child abuse and neglect, totaling almost 6 million children, according to the U.S. Department of Health and Human Services.

Poor and single with children
The study worked with 35 families screened through the Texas child welfare agency Child Protective Services, CPS. The parents had abused or neglected their children at least once, but CPS determined it best the family stay together and receive services to improve parenting and end the maltreatment.

In all the families, the mother was legal guardian and primary caregiver and typically had three children. On average she was 28, single and had an annual income of $10,300. Children in the study ranged from 3 to 8 years old.

Half the families in the study received Project Support parenting education and support. The other half received CPS’s conventional services.

New parenting skills + help
Mental health service providers met with the 17 Project Support families weekly in their homes for up to 6 months.

During that time, mothers, and often their husbands or partners, were taught 12 specific skills, including how to pay attention and play with their children, how to listen and comfort them, how to offer praise and positive attention, how to give appropriate instructions and commands, and how to respond to misbehavior.

Also, therapists provided the mothers with emotional support and helped them access materials and resources through community agencies as needed, such as food banks and Medicaid. The therapists also helped mothers evaluate the adequacy and safety of the family’s living arrangements, the quality of their child-care arrangements and how to provide enough food with so little money.

Services provided to families receiving traditional child welfare services varied widely. The range of services included parenting classes at a church or agency, family therapy or individual counseling, videotaped parenting instruction, anger-management help, GED classes and contact by social workers in person or by phone.

Fewer recurrences of abuse
Only 5.9 percent of the families trained through Project Support were later referred to CPS for abuse, compared with almost 28 percent of the control group, the researchers found.

“The results of this study have important implications for the field of child maltreatment,” said SMU’s Rosenfield.

Project Support was launched in 1996 to address the mental health problems of maltreated children and children exposed to domestic violence, both of which often lead to considerable problems for children later in life, such as substance abuse, interpersonal violence and criminal activity. Previous studies have shown the program can improve children’s psychological adjustment as well as mothers’ ability to parent their children appropriately and effectively, according to the researchers.

Project Support: A promising practice
With funding from the U.S. Department of Justice’s Office of Juvenile Justice and Delinquency Prevention, Project Support has been included in a study evaluating 15 “promising practices” nationally for helping children who live in violent families.

Jouriles is professor and chairman of the SMU Psychology Department. McDonald and Rosenfield are associate professors.

Other researchers were William Norwood, University of Houston; Laura Spiller, Midwestern State University; Nanette Stephens, University of Texas; Deborah Corbitt-Shindler, SMU; and Miriam Ehrensaft, City University of New York.

Tags David Rosenfield, Deborah Corbitt-Shindler, Dedman College, Ernest Jouriles, Renee McDonald, SMU Department of Psychology, SMU Family Research Center

Culture, Society & Family Health & Medicine Mind & Brain

Mad? Sad? Glad? People with severe mental illness can’t easily “read” their partner’s feelings; but there may be help

Post author By Margaret Allen
Post date June 28, 2010

For a healthy couple in a romantic relationship, getting along can be hard enough. But what if one person has been diagnosed with schizophrenia, bipolar disorder or major depression?

Adding severe mental illness into the mix can make it even harder to keep a relationship healthy, happy and satisfying, say psychologists Amy Pinkham and Lorelei Simpson, both assistant professors in the Department of Psychology at Southern Methodist University, Dallas.

A new research project by Pinkham and Simpson aims to understand how relationships function where one person has been diagnosed with a severe mental illness. Their study takes a close look at how couple relationships function when one partner has difficulties with the important social ability called “social cognition.”

Failure to understand emotional cues

Social cognition is the ability to understand social information and accurately read and interpret another person’s feelings, to understand their perspective, and then respond appropriately.

Social cognition is commonly lacking or deficient in people with severe mental illness, say Pinkham and Simpson. For example, an ill individual may think their partner is angry when in fact the person is unhappy.

Understanding these deficits could lead to treatments to address social cognition deficits within relationships, say Pinkham and Simpson.

Pinkham and Simpson hope to develop programs for people with severe mental illness to help them improve the social skills critical for them to maintain a happy relationship.

“Understanding a partner’s viewpoint and emotions is key to many relationship skills,” says Simpson. “The social cognition deficits among people with severe mental illness may help explain their greater risk for relationship distress.”

More episodes of domestic abuse
People with severe mental illness tend to have more episodes of intimate partner violence and greater relationship discord, say Pinkham and Simpson. It’s possible that deficits in social cognition may play a role in these negative outcomes, they say.

Over the next few months, the researchers will recruit 60 couples from ethnically diverse backgrounds between the ages of 18 and 65. They will compare social cognition deficits and relationship functioning in couples in which one partner has a severe mental illness to couples in which neither partner has severe mental illness.

The researchers will assess the couples and analyze the data over the next 12 months. The Texas-based Hogg Foundation for Mental Health has awarded the psychologists a one-year, $15,000 grant to fund the study.

Study may provide treatment roadmap

Pinkham and Simpson say they expect to find that impairments in social cognition do detract from a couple’s efforts at a happy relationship.

They hope this initial study will improve understanding of the problems leading to relationship distress that are commonly seen in these couples.

They also expect that the study will lead to longitudinal and treatment studies that will enable them to develop recommendations for treatment and therapy that can help people with severe mental illness overcome the deficit.

“In the last five years, several treatment programs have been developed that show considerable promise for improving social cognitive abilities in individuals with a severe mental illness. If we find that social cognition does contribute to relationship satisfaction, we may be able to extend these same treatments to couples therapy,” says Pinkham.

Pinkham has expertise in social cognition and has investigated social cognitive impairments in people with severe mental illness for the past 10 years. Simpson’s expertise is with couple relationship functioning, couples therapy and couples facing severe mental illness.

About 6 percent of people in the United States suffer from serious mental illness, according to the National Institute of Mental Health.

Due to newer, more effective medications, as well as advances in behavioral therapy, more people with severe mental illness are able to function at higher levels, including maintaining long-term relationships like marriage, say the psychologists.

First study of its kind
However, the illness still takes a toll on people with severe mental illness and their relationships with others. Improving their ability to function is essential for better quality of life, say Pinkham and Simpson.

Over the past 20 years, researchers have studied severe mental illness and social cognitive impairment. But this will be the first study to examine the role of social cognition in how couple relationships function when one person has severe mental illness, say Pinkham and Simpson.

Much of the research on severe mental illness has focused on treating symptoms. But treating symptoms doesn’t necessarily give them skills by which to improve their relationships, say Pinkham and Simpson.

The Pinkham-Simpson study is one of 12 Texas research projects to receive funding from the Hogg Foundation, which was founded to promote improved mental health for Texans.

“Academic research is an important tool in our quest to understand the complexities of mental health,” said Octavio N. Martinez Jr., executive director of the foundation in announcing the awards. “The Hogg Foundation selected these projects because they address issues that profoundly affect people’s lives.”

Tags Amy Pinkham, Lorelei Simpson, Lorelei Simpson Rowe, SMU Department of Psychology

Breakthrough “CART” treatment better than traditional cognitive therapy at altering hyperventilation and panic symptoms

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How a child turns out determined by nature, nurture — and parental guidance shaped by child’s strengths

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