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By Daniel Freeman and Jason Freeman

Students are often told — perhaps by excited friends or nostalgic parents — that university is the best time of their life. Well, for some people these years may live up to their billing. For many others, however, things aren’t so straightforward. College can prove more of a trial than a pleasure.

In truth it’s hardly surprising that many students struggle with university life. For one thing, it’s probably the first time they’ve lived away from home. College involves all sorts of potentially daunting changes and challenges with the young person’s support network of family and friends usually many miles away.

It isn’t only university life that students may be struggling with. Many common psychological problems also tend to develop around this stage of life. Depression, phobias, social anxiety, panic disorder, insomnia, alcohol problems, eating disorders, sexual problems — all typically begin during adolescence or early adulthood.

Whether students arrive at university with these problems, or develop them while there, coping with mental health issues alone and in a strange town can be particularly difficult. It’s not made any easier by the assumption that you should be having a ball.

When we think about mental health, one issue that is often overlooked is gender. Yet who is more likely to develop almost all of the psychological problems we’ve mentioned? The answer is clear: women.

Indeed, although it’s commonly asserted that rates of psychological disorder are virtually identical for men and women, when one takes a careful look at the most reliable epidemiological data a very different picture emerges.

Contrary to received wisdom, overall rates of psychological disorder are not the same for both sexes. In fact, they are around 20-40% higher in women than in men. Depression, for example, affects approximately twice as many women as men. The same is true for anxiety disorders. Women are anywhere from three to ten times more likely to develop eating disorders such as anorexia and bulimia nervosa. There’s good evidence to suggest that women are more vulnerable to both sleep disorders (primarily insomnia) and sexual problems (such as loss of desire, arousal problems, and pain during sex — all of which are classified as psychological issues).

This doesn’t mean, of course, that mental illness is an exclusively female problem — far from it. Very large numbers of men experience depression and anxiety, for example.

Nevertheless, though men tend to be prone to so-called externalizing disorders such as alcohol and drug problems and anti-social personality disorder, while women are more susceptible to emotional problems like depression and anxiety, the figures aren’t equal. If the epidemiological data is reliable, women clearly outnumber men for psychological disorders as a whole.

How do we explain this phenomenon? Why is it that women appear to be more vulnerable to mental illness than men? Well, this is an under-researched area. In the case of certain disorders — depression, most notably — some useful work has been done on gender. For most conditions, however, we have little evidence for why men and women are affected differently.

Things are especially tricky because mental illness is seldom the result of just one factor: a complex mix of genetic, biological, psychological, and social causes is often involved. Yet patterns do emerge from the limited research that has been conducted into the links between gender and mental health. What stands out is the stress caused by life events and social roles.

It’s certainly plausible that women experience higher levels of stress because of the demands of their social role. Increasingly, women are expected to function as career woman, homemaker, and breadwinner — all while being perfectly shaped and impeccably dressed: “superwoman” indeed. Given that domestic work is undervalued, and considering that women tend to be paid less, find it harder to advance in a career, have to juggle multiple roles, and are bombarded with images of apparent female “perfection”, it would be surprising if there weren’t some emotional cost. Women are also much more likely to have experienced childhood sexual abuse, a trauma that all too often results in lasting damage.

How do these environmental factors affect the individual? At a psychological level, the evidence suggests that they can undermine women’s self-concept — that is, the way a person thinks about themselves. These are the kind of pressures that can leave women feeling as if they’ve somehow failed; as if they don’t have what it takes to be successful; as if they’ve been left behind. Body image worries may be especially damaging. Then there’s the fact that women are taught to place such importance on social relationships. Such relationships can be a fantastic source of strength, of course. But to some extent we’re relying on other people for our happiness: a risky business. If things don’t work out, our self-concept can take a knock.

Perhaps then, part of the reason why so many common psychological disorders begin in adolescence and early adulthood is because this is the time when young people start to take on the demands of their conventional adult role. If those demands are more stressful for women than men that may help explain why we see young women start to outnumber young men when it comes to psychological problems.

But we need more evidence. The best answers will come from longitudinal studies: following representative cohorts over a number of years from childhood into adulthood, and carefully measuring the interaction between biological factors, life events, and mental illness.

Such research is complex and expensive, but given the extent of the burden on society and individuals alike, understanding what causes mental illness and thus being better placed to prevent and treat it should need no justification. Yet we cannot assume, as so many have done, that gender is merely a marginal issue in mental health. In fact, it may often be a crucial element of the puzzle.

Daniel Freeman is Professor of Clinical Psychology and MRC Senior Clinical Fellow, Oxford University. Jason Freeman is a freelance writer and editor. Together they wrote The Stressed Sex: Uncovering the Truth About Men, Women, and Mental Health, Anxiety: A Very Short Introduction, and Paranoia: The 21st Century Fear.

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Image Credits: (1) Stressed student. Photo by Alexeys, iStockphoto. (2) Hard study. Photo by Oliver, iStockphoto.

The post The best of times? Student days, mental illness, and gender appeared first on OUPblog.

5 Stars Back to Front and Upside Down! Claire Alexander Eerdmans Books for Young Readers No. Pages: 26       Ages: 4 to 7 ............... From front jacket flap:  It’s the principal’s birthday, and the class is busy writing cards for the special occasion. But Stan’s letters tumble out in a muddle. With a friend’s help, Stand [...]

Obsessive Compulsive Disorder (OCD) is an often misunderstood anxiety disorder. It’s treatment of choice, a form of Cognitive Behavioral Therapy known as Exposure and Response Prevention (ERP), is likewise difficult to grasp and properly use in therapy for both consumers and their therapists. This is in part because of the counter-intuitive nature of ERP, as well as the subtle twists and turns that OCD can take during the course of treatment.

Dr. Allen Weg, a licensed psychologist, has perfected the art of storytelling and metaphor use as a way of explaining and employing ERP to his clients in therapy. He utilizes this same technique to train other therapists in the use of ERP for OCD. In this brief, entertaining video, Dr. Weg walks you through 3 of those stories, and introduces you to his book entitled, OCD Treatment Through Storytelling: A strategy for successful therapy, a collection of more than 50 such stories that he has developed over the last 25 years in his work with OCD.

Click here to view the embedded video.

Whether a person has reached a new phase of an existing career or pursuing a new one, there is always a settling-in phase involved.

The person must go through at least three distinct steps during this phase.

• Astonishment at having arrived at the new status
• Panic at the thought of establishing new self-expectations, abilities, and reputation
• Developing new coping mechanisms and strategic schemes for advancement within that status

The survival process can be either pleasant or not, depending upon the approach used. That approach depends largely on whether the person sought the change in career status or arrived there at someone else’s behest. The least objectionable attitude to assume, nonetheless, is one of acceptance. Stress reduction during the process is paramount. Acceptance breeds calm responses.

New Status Astonishment

If your new status was actively sought on your part, now would be a good time to show everyone that belief in yourself and your capabilities. Obviously someone believed in you or you wouldn’t be in this new position. If you didn’t seek the status, you can always bow out gracefully, without losing face. It’s entirely up to you. You answer the person or organization with a simple No Thank You, and leave it at that.

Let’s assume you’re a writer. You’ve just landed a plum assignment from a pitch you made to a glossy magazine. NOTE: You pitched it, you believed in it. Now deal with it.

The editor loved the idea and is contracting you to run with it. NOTE: You’re at this stage because you’ve learned how to market yourself, your ideas, and your talent. Accept that someone else believes in you and your potential to generate quality product to fulfill that contract.

Panic at New Responsibilities and Expectations

It doesn’t always follow that because you sought this change in status, you understood the responsibilities and expectations that go with it.

Greater belief by others in your abilities settles the mantle of responsibility for quality, punctuality, and consistency squarely on your shoulders. You might not have considered that side of the equation when seeking your elevation. There is no need to panic.

If you’ve strived in the past to provide quality and accuracy in your work, you’ve covered the first and last of those responsibilities. If you’ve set deadlines for yourself and kept them on a consistent basis, you’ve already covered that expectation as well. Panic comes with unfamiliar territory, unfamiliar needs being placed on a person’s career plate. If you took the time before to cultivate your skills to give those factors mentioned above, you’re going to be fine.

If you haven’t yet cultivated those factors, now would be a good time to start. Take it slow. No one is forcing you to be perfect with each second of the day. Take the time to get comfortable with these new expectations. Find a mentor to help you ease into thi

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By Michael Otto

In the New York Times, Gretchen Reynolds posed the question, “Does exercise really boost your mood?” There is a clear, clean answer to this question – yes!  In fact, the evidence that regular, moderate exercise can boost your mood is overwhelming.  From population-based studies to well-controlled clinical trials – exercise is associated with better mood.  Specifically, exercise is linked with less depression and improved well-being, decreased anger, decreased anxiety, and greater feelings of social connectedness.  Exercise also improves brain functioning, and has dramatic effects on overall health. These findings have been documented repeatedly in both human and animal studies (in animal studies, depression and anxiety are assessed by behavioral responses to specific tasks).  So if the evidence is consistent, why question the effects exercise has on mood?

The motivation behind this question was a recent paper from German researchers that investigated the effects of a 3-week intense running schedule in mice.  The mice really were churning it out on the running wheel – pawing their way to an average of 12 kilometers (over 7 miles) each day.  But apparently they were not feeling cheery; the mice showed an increase rather than a decrease in anxiety behavior.  It is not clear what to make of these findings, and they don’t parallel findings in humans.  Even among marathon runners, who put in long distances similar to the mice in this study, the effects of exercise on mood appear to be positive.

This is not to say that exercise will always improve mood. For example, over-exertion and worries about physical appearance are great ways to sap motivation to continue exercise.  Also, feelings during exercise are highly variable, especially when the intensity of exercise is vigorous. The beauty of exercise for mood is that you don’t have to run yourself miserable to get the mood benefits.  Moderate exertion is enough to help you experience the desired mood benefits after exercise.

Yet the real challenge of exercise for most Americans is actually doing it.  Focusing directly on the immediate mood and stress-reducing effects of exercise can help with this challenge. Instead of drudgery directed at a distant goal of a fitter, slimmer you; exercise can be used to achieve the immediate goal of a happier, less-stressed you. But still people need to learn how to manage the thinking and procrastination patterns that can derail good exercise intentions. Motivation has been well researched, and there is an increasing role for psychologists in aiding the physical and mental health of Americans by helping them understand and change the many factors that can sap motivation.  It is now timely for Americans to take advantage of this accumulated wisdom for their own direct benefit, on or off the running wheel.

Michael Otto, Ph.D., and Jasper Smits, Ph.D., are behavior change experts and authors of Exercise for Mood and Anxiety Disorders: Proven Strategies for Overcoming Depression and Enhancing Well-Being.

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Rae: My True Story of Fear, Anxiety, and Social Phobia

Chelsea Rae Swiggett

Health Communications, Inc., 2010

ISBN: 978-0-7573-1527-5

$11.95

Rae is a true story of an adolescent girl who really struggles with different psycho-social aspects of her life. She feels really uncertain of herself and everyone around her, and is unable to function socially. In addition, she is very shy, and awkward when she is around adolescents her own age.

Rae suffers from frequent panic attacks. For instance, Rae panics when a plane flies overhead. When she is called on in class to speak up or to make a presentation, this sends her over the edge. She fears the unknown, life, death, people, and even fear itself.

By the time Rae reaches ninth grade, she feels completely isolated, and convinced that everyone is mocking her, judging her, and picking her apart. What a painful way to live. No one can keep living this way for too long without some help and encouragement.

As I read this book, I started remembering how awkward I felt when I was an adolescent, and how difficult social interactions with my peers were for me. I found the book absolutely entrancing. The book is written in a style that adolescents will understand and be able to relate to. After reading this book, hopefully adolescent girls will take steps not to fall into similar patterns of destructive patterns and behaviours.

Reviewed by Amy M. O’Quinn

I was an anxious child—always worrying and fretting about what ‘could’ happen, and I am sure that my parents often wondered how to handle the situation. One of my children has inherited this ‘anxiety’ gene, and there are many times when I am at a loss of how to help her cope, even though I experienced the same feelings when I was younger. I admit that it is easy to become overwhelmed when you don’t know what to say or do in order to make everything better. And yes, frustration can result.

However, Dr. Laurie Zelinger, PhD and her son, Jordan, have written a book that is the perfect resource for children (and their parents) who experience anxiety. The book, Please Explain “Anxiety” to Me! Simple Biology and Solutions for Children and Parents, is written FOR children and simply (yet thoroughly) helps them understand their anxious feelings and strategies for dealing with them. The Zelingers use dinosaurs in a ‘story type’ format to present the material, then correlate that same information to the human body. They also use the example of a ‘switch’ being turned on when anxious feelings arise. Children will certainly enjoy this book.

I was amazed by how the Zelingers were able to take a complex biological concept and present it in such an easy and relevant way for children to comprehend and apply to their own situations. Well done! I also learned a lot about the nervous system myself and why our bodies respond in certain ways to feelings and stimuli! Additionally, I now have some simple strategies and solutions to suggest (such as breathing in and out, walking, relaxation, and distraction), when my daughter feels anxious.

I was also encouraged to know that ‘anxiety’ is common, and it is something that apparently can be carried forward from generation to generation. I believe that being informed is the first step in dealing with any difficult situation, and the Zelingers have given me that information and the tools I need to help my child (and others) who experience fear, worry, and anxiety. Highly recommended.

To learn more about Please Explain “Anxiety” to Me! or the Zelingers, go to www.drzelinger.com. You can also find out more about the book at www.lovinghealing.com.

Title: Please Explain “Anxiety” to Me! Simple Biology and Solutions for Children and Parents
Authors: Laurie Zelinger, Ph.D. and Jordan Zelinger
Publisher: Loving Healing Press (July 23, 2010)
ISBN-10: 1615990291
ISBN-13: 978-1615990290

Welcome to Day 4 of the 6-day virtual tour for my new book Please Explain "Anxiety" to Me! I believe you to have to know kids to be able to write for and about them. When a child is referred to me and I meet him or her for the first time, I tell the child that I know all about children. I know what kids think about and dream about and worry about. I am a mommy and I am also a psychologist. I help kids, teachers and parents figure out how to help a child feel happier. I also tell the child, very frankly, that I know he/she has a problem with ______ and that I know how to talk about it since I’ve heard things like that before. You need to forge trust with a child in your care in order for that child to share his inner most thoughts with you. Then, when you have a true grasp of the issues and can talk about it with clarity and ease, you can begin to write about it from a position of authority but in language that is familiar to the child.

I saw my task in Please Explain Anxiety to Me as the attempt to de-mystify a complex concept (anxiety) so it could be understood better by a child experiencing symptoms of anxiety. That is how I came upon the notion that the sympathetic nervous system is like a switch that flips on and off depending upon our perception of danger, and it is that “switch” image that I use throughout the book to explain when anxiety is adaptive and when it is unwelcome.

When I was a student studying personality testing, we were taught that children typically infuse animal characters in their stories and play, and as they grow they incorporate more human figures. Remembering this, I wrote my second book with dinosaurs as the theme characters. I feel it is important to scaffold information you present to a child, so that you start with something the child already knows or can identify with, and build from there, introducing new concepts as the child actively modifies his existing fund of information to incorporate the new material.

It is also important to be conversant with typical vernacular for your target age group and to use shorter sentences with younger children, as their attention and receptive vocabulary are limited in the early years. Books that teach should utilize everyday language so that children are not put off by both words and concepts that are unfamiliar. You don’t want a child to have to work hard at untangling vocabulary in order to understand the message. Some children will lose interest if the effort required is too great. However, there is definitely a place for books with lovely and descriptive language, but those are best enjoyed during relaxing moments when the pressure to learn is reduced and the modality of language can be appreciated.

Illustrations are also a powerful form of communication and often re-appear as “day residue” in a child’s dreams. In my experience, when children are referred because of particular fears, they often cite books or movies with scenes that contain haunting visual details. I sometimes wonder if illustrators recognize the enduring effect of their creative imaginations upon the sleep habits of their young readers. The written word, the reader’s voice and the c

Dr. Laurie Zelinger is a New York State Licensed Psychologist as well as a Certified School Psychologist in New York State, New York City, and New Jersey. She is also a Registered Play Therapist/Supervisor of the Association for Play Therapy and in April 2009, was elected to the position of “Director” on the Board of Directors for the New York State branch of the organization. Dr. Zelinger has additional certification in the following areas: The Grieving Child Bereavement Certification, Banana Splits Divorce Program, Child Abuse Prevention, NYS OMRDD Behavior Management of Aggressive Clients, and in CPR (including updated re-certification). Dr. Zelinger recently completed certification as a Red Cross Disaster Mental Health Team Associate Volunteer.

She has given numerous presentations to professional associations, such as the international conference on the Association of Play Therapy, National Association of School Psychologists and presentations to many teacher and parent groups.

Jordan Zelinger is a graduate of Union College where he earned his BS degree in Neuroscience and is now pursuing his doctoral degree in School-Clinical Child Psychology at Pace University in New York City. Jordan enjoys working with typically developing children as well as those who have special needs, and has worked in preschool classrooms with both during the summers. He collaborated with his mother on this, his first book, drawing upon his background in psychology and biology. He hopes to apply his skills in community and school settings, as he begins to embark on his professional career.

These questions came to me from a group of writers. Apparently it’s a topic frequently discussed on forums and blogs and I suppose shared anxiously through emails and phone calls. These authors, all agented, wanted to know if I am aware, or other agents are aware, of the insecurities and concerns of a writer. In this case they were specifically talking about those long stretches of silence when they are waiting to get feedback on revisions, waiting to hear that the book is going out on submission or just waiting for a response to an email or phone call.

I think that most agents are aware of a writer’s anxieties and insecurities, it’s probably even easier to be aware now with blogs and the Internet than it ever was before. I know that I’ve learned a lot from my readers and what is posted in the comments. I’ve also learned a lot from perusing writing groups and forums. However, being aware of general writer worries and reacting to them are two different things. As an agent I need to be considerate of the feelings of my clients, but I also can’t assume that all of them feel the same way. What I try hardest to do is be considerate. I try to let my clients know roughly when I’ll get to the material I have to read, I try to keep them in the loop as much as possible on their submissions, and I let them know that at any point if they are feeling insecure or worried they should feel free to get in touch.

The difficult thing about insecurities is that you can’t expect someone else to take care of them for you. We all have them and yes, agents experience times of insecurity too. Who wouldn’t? It’s a business where you fall in love with something with all of your heart and then have to try to find that one other person who feels the same way. That’s enough to make all of us batty.

My suggestion for dealing with your insecurities is to figure out how to calm yourself without making others crazy. Easier said than done, I know. The trick to quelling anxiety is to take control. No you can’t go to your agent’s office and force her to read your material or send it out on submission, but you can talk openly and frankly about timelines. When does she think she’ll have feedback to you or what is her thought on when the submission process will start? Getting an agreement on dates might not necessarily mean it will happen by the date chosen. I know for example there are times I’ll tell an author I’m starting the submission process the next day, only to discover it’s taken me two days just to finalize the query and another day to get my head wrapped around which editors I think would be most enthusiastic about the work. I have no problem with the author checking in though, especially if I had told her I was going to be starting.

I know that some of you are going to immediately chime in about how this is all well and good if you have a good agent who does communicate, but what about the bad agents? We talk about the “bad” agents a lot and we hear the horror stories of those who were lost in piles and never hear from the agents they work with. Those are horror stories and hopefully not as common as the good stories. I got the impression from this group of readers that all were happy with their agents, just anxious, and being anxious about working with an agent certainly does not mean the job isn’t getting done.

Jessica

It is a wet and miserable Sunday morning and my sense of humour is grim and black I am sitting thinking of how we communicate and how at times the words we use does not convey our true feelings.

What do we say when someone asks “How are you?” are we always candid in our response? Some of my own responses and the corresponding emotions.

• I’m alright
• (Have I any choice).
• I’m always alright
• AGAIN. Have I any choice?
• I am fine
• I feel I could die
• I am ok
• I feel like crap.
• I’ve had a good day
• Nothing has been broken/destroyed
• I’ve had a great day
• No-ones been injured
• I’m Perfectly fine
• I’d really like to die. Now –Please.

Image by oddsock via Flickr

Edward Munch’s The Scream is supposed to reflect the universal anxiety of man. I think it reflects my inner being down to a tee more than anything I could ever say. I don’t know about anxiety but I feel sometimes like I’m going to go mad and would love to scream! Today, my humour is very black

It is a wet and miserable Sunday morning and my sense of humour is grim and black I am sitting thinking of how we communicate and how at times the words we use does not convey our true feelings.

What do we say when someone asks “How are you?” are we always candid in our response? Some of my own responses and the corresponding emotions.

• I’m alright
• (Have I any choice).
• I’m always alright
• AGAIN. Have I any choice?
• I am fine
• I feel I could die
• I am ok
• I feel like crap.
• I’ve had a good day
• Nothing has been broken/destroyed
• I’ve had a great day
• No-ones been injured
• I’m Perfectly fine
• I’d really like to die. Now –Please.

Image by oddsock via Flickr

Edward Munch’s The Scream is supposed to reflect the universal anxiety of man. I think it reflects my inner being down to a tee more than anything I could ever say. I don’t know about anxiety but I feel sometimes like I’m going to go mad and would love to scream! Today, my humour is very black

Cassie, Publicity

Anthony Scioli is Professor of Clinical Psychology at Keene State College. Henry Biller is Professor of Clinical Psychology at the University of Rhode Island. Their new book, Hope in the Age of Anxiety, is a look at how we can be happy and healthy in a world filled with economic collapse, natural disasters, poverty, and the constant threat of terrorism. In this excerpt, they look at how finding meaning can positively affect your health.

What is meaning in life? Many lengthy philosophical essays have been written on this topic, but one of the most compelling descriptions can be found in a pithy five-page article written by philosopher Robert Baird. In Meaning in Life: Created or Discovered, Baird reduced the meaning-making process to three essential life tasks: cultivating depth and quality in your relationships, committing yourself to projects and goals, and fashioning stories that place your life in an ultimate context. Note that, once again, the big things in life come down to attachment, mastery, and survival, or in other words, hope. Perhaps this is why theologian Emil Brunner proclaimed: “What oxygen is to the lungs, such is hope to the meaning of life.”

Meaning in life is both a destination and a vehicle. As a destination, a meaningful life can be viewed as a desired end state or goal: every human being has a need to lead a life that makes sense to him or her on a personal level. As a vehicle, meaning making can pave the way to better health: being fully engaged in the flow of life and having a deep sense of purpose can make you more resistant to illness and extend your life. In both senses, the personal meaning in one’s life, like a potentially effective exercise program, usually requires some adjustment if it is to be sustained over time, and for many, that adjustment includes the incorporation of established traditions such as religious faith. But regardless, the meaning that one finds in life supports health because it solidifies hope.

Meaning as a health destination. Meaning is hardly a luxury item for a social animal endowed with prominent frontal lobes and a keen sense of future survival. Meaning is basic to human life. No amount of money or power can take its place. If these earthly gains sufficed, we would never see many of those who have them in spades destroy themselves with drugs, eating disorders, or other self-destructive behaviors. Horace Greeley put it well, “Fame is a vapor, popularity an accident . . . riches take wings.”

Meaning as a vehicle to better health. Individuals infused with meaning are well anchored. They have strong relationships, a potent sense of mastery, and an unwavering sense of purpose. In short, they are brimming with hope. What are the health benefits of such deep centeredness? Psychiatrist Viktor Frankl observed that those of his fellow prisoners at Auschwitz who were able to sustain some sense of purpose were less likely to succumb to illness. More than even food or medical care, a meaning-oriented outlook preserved the immune systems of these survivors.

Psychologist Carol Ryff has been among those who believe that meaning and purpose in life reduces allostatic load, the wear and tear of biological reactivity to stress. To the extent that spiritual beliefs impart meaning, this may be why high religious involvement tends to be associated with fewer cardiovascular crises and greater longevity. In a sense, the meaning-centered individual is less likely to be tossed adrift by what Shakespeare dubbed the “slings and arrows of outrageous fortune.”

Ryff and her colleagues tested the meaning hypothesis by studying 134 women, ages 61 to 91. They assessed both hedonic (joy and happiness) and eudaimonic well-being (meaning and purpose). Greater meaning and purpose, rather than more joy and happiness, emerged as the better health predictor. Specifically, those who reported greater eudaimonic well-being had lower levels of stress hormones and inflammatory cytokines as well as higher levels of HDL (”good” cholesterol). They also had a healthier body mass index.

The ability to derive meaning is also important for those already diagnosed with a serious illness. Denise Bowes of Dalhousie University in Nova Scotia and her colleagues conducted detailed interviews of nine women diagnosed with ovarian cancer. “Hope” and “finding meaning” were the two most important factors that determined perceived well-being. As one woman put it, “If you don’t have hope, then you don’t have anything really.”

The role of meaning as an illness buffer seems to be especially important for older individuals. One of us (A. S.), in collaboration with psychologist David McClelland, explored the impact of derived meaning, chronic illness, and age on reported morale in 80 younger (25 to 40) and 80 older (65 to 80) adults. The findings were fascinating. Older individuals were better able to derive meaning from experiences with illness than their younger counterparts. In addition, despite reporting twice as many chronic illnesses as the younger group, the older adults had significantly higher levels of morale. What accounted for this surprising finding? It appeared to be derived meaning. Among older adults, meaning was the strongest predictor of morale, exceeding by a factor of ten to one both the importance of age and the number or severity of chronic illnesses.

Anxiety and panic often first appears in adolescence, making effective treatment, while still young, imperative. The Treatments That Work series explains the most effective interventions for a particular problem in user-friendly language.  In Mastery of Anxiety and Panic for Adolescents, Riding The Wave: Therapist Guide, by Donna B. Pincus, Jill T. Ehrenreich and Sara G. Mattis, the aim is to help adolescents with panic disorder and agoraphobia.  In the excerpt below the authors focus on the importance of parental involvement in effective treatment.

Research on the importance of including parents in child and adolescent anxiety treatment has grown substantially during the past decade.  Numerous studies indicate that children and adolescents have the most significant and lasting gains in anxiety treatment when parents are involved.  Recent systemic research has suggested that incorporating parents more centrally into the treatment of children and adolescents with anxiety disorders may enhance treatment effectiveness and maintenance (Ginsburg, Silverman, & Kurtines, 19915; adds, Heard, & Rapee, 1992).  Ollendick and King (1998) highlight the need for intensive parental involvement when treating children with fears and anxiety.  They suggest that parents might be regarded as co-therapists, responsible for the implementation of procedures developed by the therapist and for giving children or adolescents ample praise and positive reinforcement for brace behavior.  Although this may seem common-sense, a review of the literature reveals that involving parents directly in the treatment process has been the exception rather than the rule (Braswell, 1991)…Since the parent is one of the most significant persons in an adolescent’s life, and an adolescent’s avoidance of activities often causes considerable disruption in most families, the inclusion of parents in the active treatment process should yield greater clinical benefit…

General Tips for Parental Involvement

As an adolescent is learning new concepts and tools for dealing with his panic attacks, it is very helpful to have parents on the “same page” as their child.  This can be accomplished by teaching both the adolescent and his parents a “common language” regarding the most appropriate tools to use during a panic attack.  For example, during a panic attack, a parent might suggest that the adolescent “restructure his maladaptive panic thoughts” or “notice the triggers of panic attacks” and “not avoid the feelings.”  While it is important for an adolescent to know how to cope most effectively with a panic attack, it is also crucial that parents also understand how to help most effectively.  Thus, including parents in a portion of treatment sessions ensures that they will be able to help reinforce concepts that the adolescent learned in therapy.

Many parents of adolescents with panic disorder (PD) are worried that their child might be in significant distress during a panic attack, and my inadvertently reinforce the child’s avoidance of places or situations that might trigger panic.  It is important that parents are educated about the nature of anxiety and panic, the fact that anxiety won’t hurt or harm their child, and the importance of nonavoidance of physical sensations and of situations that might trigger panic attacks.  Although parents are typically given handouts and reading materials regarding the nature of anxiety and panic, it is also helpful to have parents join part of the session, to teach these importance concepts in person.

A common fear of parents of adolescents with panic is whether getting rid of their adolescent’s PD will make them feel “less close” to their child.  Parents state that, unlike many adolescents who are trying to separate from their parents, their teenager tries to “stay close” to them out of fear of getting a panic attack and having to deal with it alone.  This often makes parents feel a sense of importance and emotional closeness to their teenager.  When attempting to treat PD, it is important to discuss with the adolescent and his parents other way that they might maintain a close relationship if panic attacks were no longer occurring.

Although parents can be involved in treatment in many ways, it is important to first discuss the plan with the adolescent and parent(s), so that both parties are comfortable and aware of the plan.  In addition, the inclusion of parents at the end of sessions does not mean that they must be informed about everything the adolescent talked about in therapy; only the important treatment concepts need to be conveyed.

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HI guys! I'm back (for a little bit) - Today is actually my 1 YEAR ANNIVERSARY here in IF and also my 100th POST! So amazing how time flies...Thank you to IF and to all the wonderful friends I made this year. You are all an inspiration to me... Cheers!