New approach to mental disorders + Bullying the common factor in LGBTQ suicides

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Researchers call for new approach to some mental disorders
https://news.wsu.edu/2020/05/26/research...disorders/

RELEASE: Some of the most common mental disorders, including depression, anxiety and PTSD, might not be disorders at all, according to a recent paper by Washington State University biological anthropologists. In the paper, published in the Yearbook of Physical Anthropology, the researchers propose a new approach to mental illness that would be informed by human evolution, noting that modern psychology, and in particular its use of drugs like antidepressants, has largely failed to reduce the prevalence of mental disorders.

For example, the global prevalence of major depressive disorder and anxiety disorders remained steady at 4.4% and 4% respectively from 1990 to 2010. The authors also theorize that depression, anxiety and post-traumatic stress disorder may be primarily responses to adversity; therefore, only treating the “psychic pain” of these issues with drugs will not solve the underlying problem. Kristen Syme, the first author on the paper and recent WSU Ph.D. graduate, compared it to medicating someone for a broken bone without setting the bone itself.

“The pain is not the disease; the pain is the function that is telling you there is a problem,” said Syme. Depression, anxiety and PTSD often involve a threat or exposure to violence, which are predictable sources for these things that we call mental diseases. Instead, they look more like sociocultural phenomena, so the solution is not necessarily fixing a dysfunction in the person’s brain but fixing dysfunctions in the social world.”

Syme and co-author Edward Hagen advocate for biological anthropologists to enter the study of the “diseases of the mind,” to help find effective solutions, particularly for some problems that may be social instead of mental. “Mental health research is still very much stuck in a view that comes out of the 19th century, and revived in 1980, of classifying everything by symptoms in the hopes of revealing underlying patterns that would lead to solutions, but it really has not,” said Hagen, a WSU professor of evolutionary anthropology and corresponding author on the paper. “Even though we’re using new measurements, like genetics, biomarkers and imaging, these still haven’t added up to the insights needed to really improve people’s lives.”
Edward Hagen portrait
Edward Hagen

Among the more problematic issues, the researchers point to the “chemical imbalance” theory of depression, which has helped create a boom in antidepressant drugs meant to modulate certain chemicals in the brain called neurotransmitters. A large meta-analysis of antidepressant trials in 2018 found that antidepressants had almost the same effect as a placebo, and their widespread use has not delivered measurable results. For example, in Australia alone, antidepressant use increased 352% from 1990 to 2002, yet there has been no observed reduction in the prevalence of mood, anxiety or substance use disorders in any country.

Instead of addressing mental issues by their symptoms, Hagen and Syme propose approaching mental illness by their probable causes. They acknowledge that some psychiatric disorders like schizophrenia are likely genetic and often inherited and others like Alzheimer’s appear connected with aging. However, the anthropologists argue that some conditions might be a mismatch between modern and ancestral environments such as attention-deficit/hyperactivity disorder, also known as ADHD. Hagen pointed out that there is little in our evolutionary history that accounts for children sitting at desks quietly while watching a teacher do math equations at a board.

Other disorders such as depression, anxiety and PTSD are not hereditary, occur at any age and are often tied to threatening experiences. Hagen and Syme propose they may be responses to adversity and serve as signals, much like physical pain does, to make people aware of the need for help. These conditions also disproportionately affect people in developing countries. For instance, 1 in 5 people in conflict-affected countries suffer from depression versus 1 in 14 in worldwide. “As anthropologists, we should be studying this a lot more because the mental health burden in the populations we often study is quite high,” Hagen said. “In many cases, they’re suffering from pervasive warfare, conflict and inadequate policing.”



Bullying is common factor in LGBTQ youth suicides, Yale study finds
https://news.yale.edu/2020/05/26/bullyin...tudy-finds

RELEASE: Researchers at the Yale School of Public Health have found that death records of LGBTQ youth who died by suicide were substantially more likely to mention bullying as a factor than their non-LGBTQ peers. The researchers reviewed nearly 10,000 death records of youth ages 10 to 19 who died by suicide in the United States from 2003 to 2017. The findings are published in the current issue of JAMA Pediatrics.

While LGBTQ youth are more likely to be bullied and to report suicidal thoughts and behaviors than non-LGBTQ youth, this is believed to be the first study showing that bullying is a more common precursor to suicide among LGBTQ youth than among their peers. "We expected that bullying might be a more common factor, but we were surprised by the size of the disparity," said lead author Kirsty Clark, a postdoctoral fellow at Yale School of Public Health. "These findings strongly suggest that additional steps need to be taken to protect LGBTQ youth -- and others -- against the insidious threat of bullying."

Death records from LGBTQ youths were about five times more likely to mention bullying than non-LGBTQ youths' death records, the study found. Among 10- to 13-year-olds, over two-thirds of LGBTQ youths' death records mentioned that they had been bullied.

Bullying is a major public health problem among youth, and it is especially pronounced among LGBTQ youth, said the researchers. Clark and her co-authors used data from the National Violent Death Reporting System, a Centers for Disease Control and Prevention (CDC)-led database that collects information on violent deaths, including suicides, from death certificates, law enforcement reports, and medical examiner and coroner records.

Death records in the database include narrative summaries from law enforcement reports and medical examiner and coroner records regarding the details of the youth's suicide as reported by family or friends, the youth's diary, social media posts, and text or email messages, as well as any suicide note. Clark and her team searched these narratives for words and phrases that suggested whether the individual was LGBTQ. They followed a similar process to identify death records mentioning bullying.

"Bullies attack the core foundation of adolescent well-being," said John Pachankis, the Susan Dwight Bliss Associate Professor of Public Health at the Yale School of Public Health and study co-author. "By showing that bullying is also associated with life itself for LGBTQ youth, this study urgently calls for interventions that foster safety, belonging and esteem for all young people."
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