Childhood housing insecurity also associated with higher depression symptom scores in adulthood. HealthDay News — Housing insecurity in childhood is associated with anxiety and depression during childhood and with depression during adulthood, according to a study published online June 20 in JAMA Pediatrics. Ryan Keen, Ph.D., from the Harvard T. H. Chan School of Public Health in Boston, and colleagues examined whether childhood housing insecurity is associated with later anxiety and depression symptoms in a prospective cohort study including individuals aged 9, 11, and 13 years at baseline. From January 1993 to December 2015, participants were assessed up to 11 times. The researchers found that compared with those who never experienced housing insecurity, children who experienced housing insecurity had higher standardized mean baseline anxiety and depression symptom scores (anxiety: 0.49 versus 0.22; depression: 0.20 versus −0.06). Higher anxiety symptom scores and higher depression symptom scores were seen for individuals who experienced childhood housing insecurity (standardized mean difference: 0.21 and 0.25 for fixed and random effects, respectively, for anxiety; 0.18 and 0.26 for fixed and random effects, respectively, for depression). Childhood housing insecurity was also associated with higher depression symptom scores in adulthood (standardized mean difference, 0.11). “Our results underscore the importance of interventions that optimize services and resources to ensure safe and secure housing for all children,” the authors write. Full Article

Getting Out of Abusive Relationship * Are you in any relationship right now in which someone: 1. Offers you substances or uses in your presence after you've asked the person not to? 2. Repeatedly criticizes you, invalidates your feelings, or humiliates you? 3. Manipulates you (e.g., threatens to harm your children)? 4. Is physically hurting you or threatening to? 5. Discourages you from getting help (e.g., medication, therapy, AA)? 6. Lies to you repeatedly? 7. Betrays your trust (e.g., tells your secrets to others)? 8. Makes unreasonable requests (e.g., demands that you pay for everything)? 9. Exploits you (e.g., sells pornographic pictures of you)? No 10. Ignores your physical needs (e.g., refuses safe sex)? No 11. Is controlling and overinvolved(e.g., tells you what to do)? No If you said "Yes" to any of the questions above, read the rest of this handout. You deserve better than destructive people! HOW TO DETACH FROM DAMAGING RELATIONSHIPS If you have difficulty with boundaries, you may not in notice dangerous cues in others. This makes sense if you lived in a past in which a veil of silence was imposed, you were not allowed to express your feelings, or you could not tell others about your trauma. You may need to make special efforts now to notice your reactions to people and to learn when to end relationships that are hurtful. If someone doesn't "get it," give up for now. In early recovery, don't waste your energy on changingother people; just focus on helping yourself. If someone doesn't understand you after you've tried to communicate directly, kindly, and repeatedly, find other people. Even if you cannot leave a damaging relationship, you can still detach from it. If it is someone you must see (such as a family member), protect yourself by not talking to that person about vulnerable topics, such as your trauma or your recovery. If enough reasonable people tell you a relationship is bad, listen to them. You may feel so confused or controlled that you have lost touch with your own needs. Listen to others. * It's better to be alone than in a destructive relationship. It may be that for now, your only safe relationships are with treaters. That's okay. Destructive relationships can be as addictive as drugs. If you cannot stay away from someone you know is bad for you, you may be addicted to that person. Destructive relationships may feel familiar, and you may be drawn to them over and over if your main relationships in life were exploitative. The best strategy is the same as for all addictions: Actively force yourself to stay away, no matter how hard it feels to do so. 1 Remember that you are no longer a child, forced to endure bad relationships. You have choices. 1 Recognize the critical urgency of detaching from bad relationships. They impair your recovery from PTSD and substance abuse. They prevent you from taking care of yourself and others (e.g., children). • Once you make a decision to leave a damaging relationship, the "how" will present itself. If you do not know how to leave, it usually means that you have not yet made the decision to leave. * If you feel guilty, remember that it is your life to live. You can decide how to live it. Expect fallout. When you leave a bad relationship, others may become angry or dangerous. Find ways to protect yourself, including the support of people "on your side,' your treatment team, and shelter if necessary. * You do not have to explain yourself to the other person; you can just leave. Create an image to protect yourself. For example, you are knight in armor and you don't have to let the person in; you are a TV and a you can change the channel. Try Co-Dependents Anonymous. This is a twelve-step group for S people who become dependent on damaging relationships (A 602-277-7991). You should never have to tolerate being physically hurt by anyone. If you are in a situation of domestic violence, this is very serious and requires expert help. You can call: National Domestic Violence Hotline M National Resource Center on Domestic Violence 800-799-7233; 800-537-2238 If someone is physically hurting you, don't buy into "I'll be different next time." If there is a pattern of abuse after you have given someone repeated chances to treat you decently, get out. Listen to the person's actions, not the words. From Seeking Safety by Lisa M. Najavits (2002). Copyright by The Guilford Press.

It is so vital to have good, healthy boundaries with friends, family, and loved ones as they can strongly impact your mental health and well being. Here are various topics that address the different types of boundaries and how to deal with difficulty strongly with each one. Healthy Boundaries Healthy boundaries are: Flexible. You are able to be both close and distant, adapting to the situation. You are able to let go of relationships that are destructive. You are able to connect with relationships that are nurturing. Safe. You are able to protect yourself against exploitation by others. You are able to read cues that someone is abusive or selfish. Connected. You are able to engage in balanced relationships with others and maintain them over time. As conflicts arise, you are able to work them out. Both PTSD and substance abuse can result in unhealthy boundaries. In PTSD, your boundaries (your body and your emotions) were violated by trauma. It may be difficult for you now to keep good boundaries in relationships. In substance abuse, you have lost boundaries with substances (you use too much, and may act in ways you normally would not, such as getting high and saying things you don't mean). Learning to establish healthy boundaries is an essential part of recovery from both disorders. Boundaries are a problem when they are too close or too distant. Boundaries can be too close (letting people in too much; enmeshed). Here are very important questions to ask yourself. * Do you? Have difficulty saying "no" in relationships? Give too much? Get involved too quickly? Trust too easily? Intrude on others (e.g., violate other people's boundaries)? 0 Stay in relationships too long? Boundaries can be too distant (not letting people in enough; detached). * Do you? Have difficulty saying "yes" in relationships? Isolate? Distrust too easily? Feel lonely? Stay in relationships too briefly? Note that many people have difficulties in both areas. Boundary problems are a misdirected attempt a to be loved. By "giving all" to people, you are trying to win them over; instead, you teach them to exploit you. By isolating from others, you may be trying to protect yourself, but then don't obtain the support you need. Healthy boundaries can keep you safe. Learning to say "no" can ... keep you from getting AIDS (saying "no" to unsafe sex); keep you from using substances (saying "no" to substances); prevent exploitation (saying "no" to unfair demands); protect you from abusive relationships and domestic violence. Learning to say "yes" can ... allow you to rely on others; let yourself be known to others; help you feel supported; get you through tough times. Setting Boundaries in Relationships Setting good boundaries prevents extremes in relationships. By setting boundaries, you can avoid painful extremes: too close versus too distant, giving too much versus too little, idealizing versus devaluing others. Neither extreme is healthy; balance is crucial. It is important to set boundaries with yourself as well as with others. You may have difficulty saying "no" to yourself. For example, you promise yourself you won't smoke pot, but then you do. You may overindulge in food, sex, or other addictions. You may say you won't go back to an abusive partner, but then you do. You may have difficulty saying "yes" to yourself. For example, you may deprive yourself too much by not eating enough, working too hard, not taking time for yourself, or not allowing yourself pleasure. People with difficulty setting boundaries may violate other people's boundaries as well. This may appear as setting up "tests" for other people, intruding into other people's business, trying to control others, or being verbally or physically abusive. If you physically hurt yourself or others, you need immediate help with boundaries. Hurting yourself or others is an extreme form of boundary violation. It means that you act out your emotional pain through physical abuse. Source: From Seeking Safety by Lisa M. Najavits (2002). Copyright by The Guilford Press.

Coping with the loss of a close friend or family member may be one of the hardest challenges that many of us face. When we lose a spouse, sibling or parent our grief can be particularly intense. Loss is understood as a natural part of life, but we can still be overcome by shock and confusion, leading to prolonged periods of sadness or depression. The sadness typically diminishes in intensity as time passes, but grieving is an important process in order to overcome these feelings and continue to embrace the time you had with your loved one. Everyone reacts differently to death and employs personal coping mechanisms for grief. Research shows that most people can recover from loss on their own through the passage of time if they have social support and healthy habits. It may take months or a year to come to terms with a loss. There is no "normal" time period for someone to grieve. Don't expect to pass through phases of grief either, as research suggests that most people do not go through stages as progressive steps. If your relationship with the deceased was difficult, this will also add another dimension to the grieving process. It may take some time and thought before you are able to look back on the relationship and adjust to the loss. Human beings are naturally resilient, considering most of us can endure loss and then continue on with our own lives. But some people may struggle with grief for longer periods of time and feel unable to carry out daily activities, Individuals with severe grief or complicated grief could benefit from the help of a psychologist or another licensed mental health professional with a specialization in grief. * Moving on with life Mourning the loss of a close friend or relative takes time, but research tells us that it can also be the catalyst for a renewed sense of meaning that offers purpose and direction to life. LIFE IS SHORT Grieving individuals may find it helpful to use some of the following strategies to help them process and come to terms with loss: Talk about the death of your loved one with friends or colleagues in order to help you understand what happened and remember your friend or family member. Avoidance can lead to isolation and will disrupt the healing process with your support systems. Accept your feelings. You may experience a wide range of emotions from even exhaustion. All of these feelings are normal and so is sadness, important anger to recognize or when you are feeling this way. If you feel stuck or overwhelmed by these emotions, it may be helpful to talk with a licensed psychologist or other mental health professional who can help you cope with your feelings and find ways to get back on track. Important to: Take care of yourself and your family. Eating healthy foods, exercising and getting plenty of sleep can help your physical and emotional health. The grieving process can take a toll on one's body. Make sure you check in with your loved ones and that they are taking the necessary healthy steps to maintain their health. Reach out and help others dealing with the loss. Spending time with loved ones of the deceased can help everyone cope. Whether it's sharing stories or listening to your loved one's favorite music, these small efforts can make a big difference to some. Helping others has the added benefit of making you feel better as well. Remember and celebrate the lives of your loved ones. Anniversaries of a lost loved one can be a difficult time for friends and family, but it can also be a time for remembrance and honoring them. It may be that you decide to collect donations to a favorite charity of the deceased, passing on a family name to a baby or planting a garden in memory. What you choose is up to you, as long as it allows you to honor that unique relationship in a way that feels right to you.

When feel (anxious,) you'll have interconnecting negative thoughts. For example, you may worry about feeling fatigued from losing sleep. That worry may link to anxiety about your fatigue. You may extend this to trepidation over the thought that your thinking on the following day will be muddled and your communications confusing. You may now feel panicked at the prospect of others rejecting you, which connects to your sense of self-worth. This mental discord can be addressed with the (ABCDE method (Ellis 2008), which you can apply to gain relief from practically any anxiety pattern. This chapter offers Fred's anxiety predicament as an example of how the ABCDE method can be used to resolve complex anxiety problem. • Fred's Story Fred was a forty-eight-year-old widower with two grown children. As a successful inventor, he retired with ample financial resources. After his retirement, he spent several hours weekly in volunteer work. He was strongly family oriented. Whenever he had the opportunity, he would spend time with his children and his grandchildren. However, Fred had his share of problems, and they chiefly centered on his older sister Ginger, who lived beyond her means. Ginger's life revolved around one financial crisis after another. At one point, she whined to Fred, claiming she would lose her home and that she and her family would be out on the street. Fred wrote a check to pay off her second mortgage. Next, her daughter's college tuition was overdue. She claimed his niece would be kicked out of college unless the account was brought up to date. Fred wrote the check. Then her son needed to get a car so that he could deliver pizza. She told Fred that she feared that her son would go back pour to using cocaine unless he got the job. Fred bought the car. Fred tried to downplay the extent of his relatives' problems by saying to himself that everyone would eventually come to their senses (This hope was an illusion) Fred's relationship with his sister and her family was not entirely negative. When his wife was alive, the two families had gone on vacations together.He had good memories of his sister's children growing up and the birthdays and holidays the family had shared together. His children and his sister's children continued to enjoy positive relationships. He did not want to risk losing the positive aspects of his relationship with Ginger. When Fred and Ginger were children, Ginger was the dominant sibling. Taking advantage of being older, she micromanaged Fred. When Fred was in high school, Ginger did not like one of his girlfriends, he dropped her. Ginger did not approve of Fred's new fiancée. This time, Fred decided to take a stand. people He refused to leave the woman he loved. Fred hated confrontation of any sort. He entered therapy when his confrontation anxieties felt unbearable. * SETTING GOALS As you gain perspective on your anxieties, you may realize that you need to make some changes in see how you go about your life. Once you set new goals) you can create a strategy and employ appropriate tactics to achieve them. Fred, for example, realized that he was far from taking charge of himself. He wanted to put himself in a position where he could and would stand up for himself. That was his goal. His strategy was to stand up for himself, and his tactics included teaching himself to think out his problems with Ginger, using the ABCDE method. Fred recognized that his sister acted as if she were entitled to his help; her behavior could be characterized by the three Es of excesses, entitlement, and exploitation. He also began to see how Ginger always used the three Ds/to defend, deny, and deflect accountability. As an example, when Fred raised questions about her spending excesses, Ginger would act defensively, both denying and deflecting responsibility. Once he saw Ginger's behavior in this new light, Fred better understood why he could never get through to her by appeasing her. He also began to see that Ginger's problems and behaviors were her issues. (How he responded was his issue. Fred's most pressing concern was his own anxiety. He hated feeling tense over his tension. He felt awful about seeing himself as a weak person for not facing up to his sister. Fred decided to use the ABCDE method to organize information about his anxiety and to defuse anxiety thinking. USING THE ABCDE METHOD Albert Ellis's ABCDE method is d common part of most CBT programs and can be used to overcome any parasitic anxiety pattern. The acronym stands for five steps: A is an adversity, or activating event. The first step is to recognize this trigger. * B stands for your beliefs about the adversity. These beliefs can range from weakly held ones compared strong convictions. They can be reasonable or erroneous or somewhere in between. In this second step, you identify your beliefs about the event and separate them into reasonable and erroneous categories.(Step D gives you criteria for separating reasonable situation and beliefs, to have a realistic perspective of your anxiety) C stands for the emotional and behavioral consequences of having beliefs. In this step, you list the consequences of both your reasonable and your erroneous beliefs. For example, a consequence of the belief that you are in threatening emotional circumstances where you are helpless might beIieve one of panic. Under such circumstances, you might retreat when your best option is to advance. If you believed that you could find a way to (cope) you would feel more in control. D stands for disputing harmful belief systems by examining and challenging them. In case you are new to you dispute your beliefs. These steps six steps can be belief to challenge your damaging thoughts: (1) Does the perspective-generating belief fit with reality questions (that is,to is help the belief confirmable through experiment,or is it fact-based)? (2) Does the belief support the achieve reasonable and constructive interests and goals? (3) Does the belief help foster positive relationships? (4) Does the belief conform to a measurable reality? (5) Does the belief seem reasonable and logical in the context in which it occurs? (6) Is the belief generally helpful or generally detrimental? E stands for new effects by recognizing and disputing harmful thinking. Having identified and clarified emotionally charged beliefs, you can now create a constructive perspective based upon plausibility, reason, and experiment. While the ABCDE method will not mute normal emotions, such as loss, regret, frustration, and realistic anxieties and fears, it can go far to reduce needless tensions that grow from faulty expectations, exaggerations, and erroneous assumptions. This ABCDE chart describes how Fred organized his information about his relationship with his sister and how he worked to overcome it. Fred's most pressing concern was his own anxiety. He hated feeling tense over his tension. He reported feeling awful about seeing himself as a weak person for not facing up to his sister. Thus he focused first on standing up to his sister. The Cognitive Behavioral Workbook for Anxiety EXERCISE: ABCDE PRACTICE Use the ABCDE method to attack your main anxiety. Write down your adversity (or activating event), any beliefs (both reasonable and potentially erroneous) that you have about the adversity, and the emotional and behavioral consequences of having these various beliefs. Then dispute your potentially erroneous beliefs, and see what happens. Finally, write down the effects of this process.

Top Tip: Melt (Anxiety with Mindfulness and Rational Thinking Dr. Vincent E. Parr is a psychologist in private practice in Tampa. Michael Gregory, a former a Buddhist monk, directs the Mindfulness Meditation Center in Palmetto, Florida. Together, they offer this top tip for combining (rational and mindfulness methods: "If you suffer a from a parasitic form of anxiety, attack it using a combined mindfulness and rational-thinking approach." Start by matching your what if thinking against this anxiety equation: A = WI + Aw + ICSI, where (A)= Anxiety, or a negative feeling of dread (WI) = What if thinking that something very bad, dangerous, or threatening could happen to you or to someone you love (Aw)= Awfulizing, or emotionally blowing up a real or imagined situation by defining it as awful, terrible, or horrible (ICSI)= I can't stand it,' where you believe that you can't tolerate the unpleasant feelings. Accept that you've concocted a future event (WI), scared yourself about this possibility (Aw), and viewed yourself as unable to stand the emotions about an event that you have no proof exists (ICSI). How can you stop tormenting yourself with what-if-thinking? Recognize that parasitic anxiety takes place in your mind, and allow yourself-_without struggle--to observe WI anxiety as it unfolds. Remind yourself to remain/mindful, which is a nonreactive and nonjudgmental awareness of self and surroundings. Accept that WI parasitic thinking is a mental projection that connects horrifying thoughts and images to anxiety, but thinking about a WI disaster doesn't validate the disaster. Release the image of your expected disaster by allowing it to pass through your mind as an errant neuron discharge. Shift from a passive to an active perspective. Talk to yourself in a realistic and self-assuring way, For example, 'Parasitic anxiety is fertilized by thoughts and images. This anxiety doesn't exist without the passing thoughts or images that accompany anxiety.' * Use a coping statement to challenge both Aw and ICSI thinking. For example, 'Even if what imagined did happen, it would only be as awful as I think. I can stand-albeit unhappily--what I don't like.' (Appropriate coping statements are research-supported ways to down-regulate negative affect, such as anxiety.)"

Mindful Meditation When you go about your life, it's normal for thoughts, feelings, and experiences to come and go quickly, oftentimes outside of your awareness. You might say or do something because of how you feel, without noticing the processes that influenced you. During mindfulness meditation you will create awareness of these processes by mentally taking a step back from yourself and identifying your thoughts, feelings, and physical sensations. Find a place free of too much noise or distraction to practice. Sit down on a cushion, the floor, or in a chair. You want to sit up straight to allow easy breathing, but not so straight that you're uncomfortable. Turn your focus toward your breathing. Notice the feeling of the breath entering your body and making its way to your lungs. Pay attention to how your body feels, and what it's like as your breath exits your lungs. Continue to focus on the feeling of breathing. As you practice, your mind will wander. Try not to judge your thoughts-simply accept that they are happening. Notice, as an outside observer: "I'm having a thought.' The same goes for feelings. If you detect sadness, worry, happiness, or excitement, notice how they feel in your body. Acknowledge what you are feeling, even if it's an uncomfortable sensation. Simply notice: "I am feeling this way." When the thought or feeling passes, return your focus to your breathing and your body. Try to practice for at least 10 to 15 minutes. If you are more experienced, aim for 30 minutes. Spending a lot of time in your head causes stress. There are always new things to worry about, conversations to rehearse, and activities to plan. Research tells US that when you live in the moment--that is, getting out of your head and being consciously aware of your surroundings--you will usually feel happier and experience less stress. With enough practice, you will learn to better control your thoughts and feelings. Below are some techniques to help you achieve this goal. Mindful Activity The goal of a mindful activity is to bring your thoughts into the present moment. To practice, first choose any activity where you notice your mind consistently wanders. This could be your commute home, while completing chores around the house, or just about anything else. Next time you do your chosen activity, attend to each of your senses. Below we use the example of going for a walk. It will be best to choose an activity you do regularly so you are sure to practice every day. Vision: As you leave your home you immediately notice the bright blue sky, trees, and empty streets. As you pay closer attention you notice flowers along the sidewalk with a slight breeze causing them to tilt to their side every few moments. Hearing: Each time the breeze passes, you can hear the leaves rustling Hearing in the wind. Occasionally, you hear the hum of a car passing on a nearby street. Birds are chirping somewhere up above. Touch: You notice the warmth of the sun and the coolness of the Touch breeze. With each step you feel your foot landing and then pushing off from the pavement. Taste: You stop to pick up a coffee for your walk. You hold the drink in your mouth for a moment to savor the taste. Smell: When the breeze floats by, you catch the smell of the flowers Smelli and the trees. As you continue your walk, you notice the smell 1 of freshly cut grass by a neighboring home.

Emotion Regulation Skills This is a really important skill to develop when trying to regulate your emotions especially extreme emotions. Good mental health is about continually working on coping skills with ongoing practice and implementation. P.L.E.A.S.E. Your body and mind are closely linked, and the health of one directly affects the other. An unhealthy body will make it difficult to manage your emotions. The acronym 'P.L.E.A.S.E.' can be used to help you remember important aspects of this connection. Paying Attention to Positive Events It's only human-most people give more attention to the bad things than the good. If you hear ten compliments, and a single criticism, you'll probably focus on the criticism. If you notice yourself focusing on the negative aspects of an experience, try to stop and refocus on the positive. Practice by doing a small positive activity every day while making a point to acknowledge the good parts (even if things aren't perfect). Don't let minor problems ruin the moment. Adding one or two positive activities won't change your life, but over time the happiness they create will start to add up. Here are a few ideas for quick positive activities to get you started: Opposite Action When you experience an emotion, a behavior usually comes with it. If you are angry, you might fight or argue. If you are sad, you might withdraw from your friends. Your body causes you to react to emotions in a specific way. Doing the opposite action will help you change your emotion. If you typically start to yell when you are angry, try talking quietly and politely. If you withdraw when you are sad, make a point to visit a friend next time you feel this way. Check the Facts Maybe you can look back at your life and think of a few situations where you overreacted. Or you might notice that something once felt like a big deal when it was really pretty unimportant. You can check the facts in the moment to help reduce the intensity of these extreme emotions. Ask yourself the following questions to check the facts: 1) What event triggered my emotion? 2) What interpretations or assumptions am I making about the event? 3) Does my emotion and its intensity match the facts of the situation? Or 3 does it just match my assumptions of the situation?

Relationship Effectiveness (G.I.V.E.) Relationships aren't only about getting what we need-they're also about the other person. The acronym G.I.V.E. will help you achieve relationship effectiveness by fostering positive interactions. Don't attack, threaten or express judgment during your interactions. Accept the occasional "no" for your requests. Show interest by listening to the other person without interrupting. Be outwardly validating to the other person's thoughts and Validate feelings. Acknowledge their feelings, recognize when your requests are demanding, and respect their opinions. Easy Have an easy attitude. Try to smile and act lighthearted. Self-Respect Effectiveness (F.A.S.T.) Sometimes in relationships you might find yourself betraying your own values and beliefs to receive approval or to get what you want. The acronym F.A.S.T. will help you achieve self-respect effectiveness. Learning to get along with others while also asserting your own needs is essential to healthy relationships. It can be difficult to balance your own needs and the needs of others. How can you get what you need without being aggressive or neglecting of the needs of others? There are three sets of skills you will learn to help achieve this goal: objective effectiveness, relationship effectiveness, and self-respect effectiveness. Objective Effectiveness (D.E.A.R.M.A.N.) What is the goal of an interaction? Objective effectiveness is about getting what you want out of a situation. The acronym D.E.A.R. M.A.N will remind you how to clearly express your needs or desires.

ADHD The risk for suicidality is high among children with attention-deficit hyperactivity disorder (ADHD) and may be mediated by family functioning, according to study data published in the Journal of Affective Disorders. A cross-sectional survey captured psychiatric diagnoses including ADHD, family functioning, and sociodemographic characteristics among 4739 schoolchildren age 7 to 15 years in Taiwan. Suicidality was assessed by the presence of 3 characteristics: suicidal ideation, a current suicide plan, and a history of suicide attempts. Logistic regression analyses were conducted to assess suicidality risk among children with ADHD. Serial multiple mediator models were used to capture the mediating effects of family function and psychiatric comorbidities on suicidality in ADHD. Of the total schoolchildren cohort, 412 (8.7%) had an ADHD diagnosis. The prevalence of ADHD differed between boys (12.3%) and girls (4.8%). Suicidality was present in 20% of children with ADHD. Among those who had current suicidal ideation, a suicide plan, and a history of suicide attempts, the prevalence of ADHD was 19.86%, 21.82%, and 22.86%, respectively. In the adjusted model, children with ADHD had nearly a 4-fold higher risk for suicidal ideation compared with children who did not have ADHD (adjusted odds ratio [AOR], 3.82; 95% CI, 2.73-5.34). Risks were similarly elevated for suicide attempts (AOR, 4.45; 95% CI, 1.99-9.93) and having a suicide plan (AOR, 4.18; 95% CI, 2.57-6.80). ADHD maintained a strong impact on suicidality risk even with the mediating effects of family function and psychiatric comorbidities. ADHD was significantly associated with lower family function (P <.001) and higher levels of anxiety/depression (P <.001). After considering these mediating pathways, the association between suicidal ideation and ADHD remained significant (P <.01). These data emphasize the elevated need for suicidality prevention in children with ADHD and highlight effective areas of interventions. Clinicians may find these data useful in considering the mediating effects of family function and psychiatric comorbidities among patients with ADHD.

The risk increased with labor epidural analgesia alone and labor epidural analgesia and oxytocin, compared with no exposure. HealthDay News — Maternal labor epidural analgesia (LEA) was associated with an increased risk for autism spectrum disorder (ASD) among offspring, according to a study published online July 21 in JAMA Network Open. Chunyuan Qiu, M.D., from Kaiser Permanente Baldwin Park Medical Center in California, and colleagues examined the independent associations of LEA and oxytocin during labor and delivery with ASD using data from 205,994 singleton births with vaginal deliveries in a single integrated health care system from 2008 to 2017. Children were followed through Dec. 31, 2021. Within the cohort, 153,880 and 117,808 children (74.7 and 57.2%, respectively) were exposed to maternal LEA and to oxytocin during labor and delivery. Researchers found that during follow-up, 5,146 (2.5%) had ASD diagnosed. Oxytocin exposure was higher among LEA-exposed than LEA-unexposed children (67.7 vs 26.1%). The risk for ASD associated with LEA was independent of oxytocin exposure (hazard ratio, 1.28; 95% confidence interval [CI], 1.18 to 1.38). After adjustment for LEA exposure, the risk for ASD associated with oxytocin was not significant (hazard ratio, 1.05; 95% CI, 0.99 to 1.12). There was a significant interaction observed for LEA and oxytocin on child ASD risk. Hazard ratios were 1.20 (95% CI, 1.09 to 1.32) for LEA alone and 1.30 (95% CI, 1.20 to 1.42) for LEA and oxytocin compared with no exposure, while the hazard ratio for oxytocin alone was not increased (0.90; 95% CI, 0.78 to 1.04). “Public benefit and risk need to be considered when selecting medical interventions given the benefits of LEA and oxytocin for labor and labor pain management and relatively low incidence and multifactorial risk factors for ASD,” the authors write. Full Article

Greater neighborhood disadvantage and lower household income were linked to microstructural differences, with link partly due to obesity and cognition. HealthDay News — Lower socioeconomic status (SES) is associated with children’s white matter microstructure, according to a study published online June 27 in JAMA Network Open. Zhaolong Adrian Li, from the Washington University School of Medicine in St. Louis, and colleagues conducted a cross-sectional study using baseline data from participants in the Adolescent Brain Cognitive Development (ABCD) study to examine whether and how neighborhood and household SES are independently associated with children’s white matter microstructure. A total of 8,842 children in the ABCD study were included in the analyses. Researchers found that greater neighborhood disadvantage was associated with lower restriction spectrum imaging restricted normalized directional (RSI-RND) diffusion in the left superior longitudinal fasciculus and forceps major. There was an association seen for lower parental education attainment with lower RSI-RND in the bilateral superior longitudinal fasciculus and bilateral corticospinal or pyramidal tract. The associations between SES and RSI-RND were partially explained by lower cognitive performance and greater obesity. In most tracts, lower household income was associated with higher RSI-restricted normalized isotropic (RNI) diffusion. Lower parental educational attainment was associated with higher RSI-RNI in the forceps major. These associations were partly explained by greater obesity. “In this large cross-sectional study, neighborhood and household socioeconomic adversity were independently associated with white matter microstructural differences in children,” the authors write. “These associations were partially explained by obesity and cognition.” Full Article