TAU NEWS – Psychology & Psychiatry

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Study Finds Disruptive Children Do Not Inspire Similar Behavior in Their Siblings

Siblings are more likely to learn how not to behave, say TAU researchers

A new Tel Aviv University study published in Child Development finds that the disruptive behavior of an individual child does not encourage similar behavior in their brothers and sisters.

On the contrary, Dr. Ella Daniel of TAU's Jaime and Joan Constantiner School of Education finds that siblings, predominantly older siblings, of disruptive children tend to exhibit less disorderly behavior over time. The research, conducted in collaboration with Dr. Jennifer Jenkins and colleagues at the University of Toronto and funded by the Canadian Institute for Health Research, examines the role of sibling training on disruptive behavior during early childhood and concludes that disruptive behavior produces greater disparity — rather than resemblance — among siblings.

"The development of disruptive behavior in early childhood is extremely important, as disruptive behavior starts early in life and behavioral patterns may become stable and resistant to influence later on," Dr. Daniel says. "We found that in early childhood, children do not learn from each other how to be disruptive, violent or disobedient.

"In fact, they are more likely to learn what not to do, or how not to behave. The older siblings of young children who are disruptive tend to become less disruptive themselves over time, creating a polarizing effect on their behaviors."

Focusing on younger children

Existing research on disruptive behavior is largely focused on adolescents. The new study harnessed data assessing the rate of disruptions as witnessed by both parents to track 916 toddlers and their preschool- and school-aged siblings in some 400 families in and around Toronto.

The families examined had given birth to an infant between 2006 and 2008, and had at least one other child (younger than four years of age) at home. The researchers conducted observations and interviews with the family, including all the siblings in the family, every 18 months.

The scientists collected information when the youngest child in the family was 18, 36 and 54 months old. On these three occasions, both parents reported the disruptive behaviors of each of their children. Using advanced statistical models, the researchers were able to identify the role of siblings in the development of each child's disruptive behavior over time, taking into account heredity, parenting, social environment and shared history.

"The study teaches us that we have little to worry about one sibling being 'a bad influence' on their brothers or sisters," says Dr. Daniel. "Instead, we should be more worried of pigeon holing: that one child will be labeled as a 'black sheep,' and that all children in the family will develop based on pre-assigned roles. We should let each child develop his or her individuality, which naturally changes over time."

The researchers are currently examining the role of siblings in the development of childhood depression and anxiety.

New Virtual Reality Technology May Improve Motor Skills in Damaged Limbs

Novel training may rehabilitate impaired limbs by allowing healthy limbs to lead "by example," say TAU researchers

A combination of traditional physical therapy and technology may improve the motor skills and mobility of an impaired hand by having its partner, more mobile hand lead by example through virtual reality training, new Tel Aviv University research suggests.

"Patients suffering from hemiparesis — the weakness or paralysis of one of two paired limbs — undergo physical therapy, but this therapy is challenging, exhausting, and usually has a fairly limited effect," said lead investigator Prof. Roy Mukamel of TAU's School of Psychological Sciences and Sagol School of Neuroscience, who conducted the research with his student Ori Ossmy. "Our results suggest that training with a healthy hand through a virtual reality intervention provides a promising way to repair mobility and motor skills in an impaired limb." The research was published in Cell Reports.

Does the left hand know what the right hand is doing?

53 healthy participants completed baseline tests to assess the motor skills of their hands, then strapped on virtual reality headsets that showed simulated versions of their hands. The virtual reality technology, however, presented the participants with a "mirror image" of their hands — when they moved their real right hand, their virtual left hand would move.

In the first experiment, participants completed a series of finger movements with their right hands, while the screen showed their "virtual" left hands moving instead. In the next, participants placed motorized gloves on their left hands, which moved their fingers to match the motions of their right hands. Again, the headsets presented the virtual left hands moving instead of their right hands.

The research team found that when subjects practiced finger movements with their right hands while watching their left hands on 3D virtual reality headsets, they could use their left hands more efficiently after the exercise. But the most notable improvements occurred when the virtual reality screen showed the left hand moving while in reality the motorized glove moved the hand.

Tricking the brain

"We effectively tricked the brain," said Prof. Mukamel.

"Technologically, these experiments were a big challenge," Prof. Mukamel continued. "We manipulated what people saw and combined it with the passive, mechanical movement of the hand to show that our left hand can learn even when it is not moving under voluntary control."

The researchers are optimistic that this research could be applied to patients in physical therapy programs who have lost the strength or control of one hand. "We need to show a way to obtain high-performance gains relative to other, more traditional types of therapies," said Prof. Mukamel. "If we can train one hand without voluntarily moving it and still show significant improvements in the motor skills of that hand, we've achieved the ideal."

The researchers are currently examining the applicability of their novel VR training scheme to stroke patients.

Computerized Training Program from TAU Cuts Soldiers' Risk of PTSD

Training targets innocuous "threats" before combat to prevent post-traumatic stress disorder

Computerized attention training may prevent the flare-up of post-traumatic stress disorder (PTSD) in soldiers exposed to combat, according to a new study from researchers at Tel Aviv University.

Attention bias modification training (ABMT) — a computerized intervention — was used to help soldiers attend to pre-combat threats, reducing the risk of PTSD outbreaks post-combat, said Prof. Yair Bar-Haim of TAU's School of Psychological Sciences and Sagol School of Neuroscience, who led the research team. Four sessions of ABMT designed to enhance threat monitoring in soldiers, delivered during basic training and prior to combat deployment, mitigated the risk of PTSD following combat exposure by two-thirds.

The study was carried out in collaboration with the Israel Defence Forces, the Walter Reed Army Institute of Research, and the National Institutes of Health. The results were published in Psychological Medicine.

Focusing on a single factor

"Individuals with PTSD may exhibit alertness and hyper-excitability, the tendency to avoid threats, and an uncontrollable re-experiencing of traumatic events," Prof. Bar-Haim said. "But there is one common factor related to PTSD that emerged from our studies with soldiers over the years: a difficulty to monitor and assess potential threats.

"In 2008, we followed large groups of infantry soldiers, from basic training to actual combat. We found that soldiers who avoided potential threats presented to them on a computer screen were at greater risk for developing post-traumatic stress syndrome after actual combat.

"One would think that a combat soldier would be more attentive to external threats than a person walking down the street," said Prof. Bar-Haim. "However, psychologically, a soldier who avoids threat-processing is more likely to develop post-traumatic symptoms. Our 'threat attentional-training' facilitates protective forms of threat-processing during combat by countering inappropriate threat-avoidance patterns."

The program is now being prepared for full-scale implementation by the IDF. If the results are replicated in US troops, the US Army may follow suit. Other at-risk populations may also benefit, such as first responders like policemen and firefighters, Prof. Bar-Haim noted.

Cutting PTSD by two-thirds

719 IDF soldiers aged 18–27 years were assigned to one of two groups. The first underwent the attention bias modification training (ABMT); the second received no training at all. Symptoms of PTSD were measured at the start of the study period, at a six-month check-up, ten days following combat exposure, and four months following combat. Results showed that soldiers who trained with the ABMT protocol presented only a third of the risk to develop PTSD following combat relative to soldiers who had received no training.

The established efficacy of ABMT in the current study, the large population at elevated risk, and the low dissemination costs of ABMT warrant research into larger-scale application, said Prof. Bar-Haim. "Our data also suggest that the effects of ABMT can last up to fourteen months following initial training," said Prof. Bar-Haim. He is currently working closely with the IDF on large-scale implementation of the program in the Israeli army.

New Study Shows We Are Bad Judges of Friendship

TAU researchers find inability to determine who our real friends are limits our powers of persuasion

Most of us think that friendship is a two-way street — but that's true only half the time, according to research from Tel Aviv University and the Massachusetts Institute of Technology.

Their new joint study says only half of your buddies would consider you their own friend. People have a very poor perception of friendship ties, and this limits their ability to influence their "friends," according to the research, published in PLoS One on March 22, 2016.

If researchers can understand this limitation, companies and social groups that depend on social influence for collective action, information dissemination and product promotion could improve their strategies and interventions.

A friend indeed?

"It turns out that we're very bad at judging who our friends are," says Dr. Erez Shmueli, who conducted the study with Dr. Laura Radaelli, both of TAU's Department of Industrial Engineering, in collaboration with Prof. Alex Pentland and Abdullah Almatouq of MIT. "And our difficulty determining the reciprocity of friendship significantly limits our ability to engage in cooperative arrangements. We learned that we can't rely on our instincts or intuition. There must be an objective way to measure these relationships and quantify their impact."

The researchers conducted extensive social experiments and analyzed the data from other studies to determine the percentage of reciprocal friendships and their impact on human behavior. The team also examined six friendship surveys from some 600 students in Israel, Europe and the United States to assess friendship levels and expectations of reciprocity.

They then developed an algorithm that examines several objective features of a perceived friendship (that is, the number of common friends or the total number of friends) and is able to distinguish between the two different kinds of friendship: unidirectional or reciprocal.

"We found that 95 percent of participants thought that their relationships were reciprocal," Dr. Shmueli says. "If you think someone is your friend, you expect him to feel the same way. But in fact that's not the case — only 50 percent of those polled matched up in the bidirectional friendship category."

A matter of influence

Why is this important? According to Dr. Shmueli, influence is the name of the game.

"Reciprocal relationships are important because of social influence," says Dr. Shmueli, who utilized the "FunFit" social experiment in the course of the research. "In this experiment that analyzes different incentives for exercising, we found that friendship pressure far outweighed money in terms of motivation. We found, not surprisingly, that those pressured by reciprocal friends exercised more and enjoyed greater progress than those with unilateral friendship ties."

The researchers found that their "friendship algorithm" determined with an extremely high level of accuracy the reciprocal or unidirectional nature of a friendship. "Our algorithm not only tells us whether a friendship is reciprocal or not. It also determines in which direction the friendship is 'felt' in unilateral friendships," Dr. Shmueli says.

Lack of Sleep Tampers with Your Emotions

TAU study pinpoints neural mechanism responsible for impaired neutrality due to sleep loss

Cranky or grumpy after a long night? Your brain's ability to regulate emotions is probably compromised by fatigue. This is bad news for 30 percent of American adults who get less than six hours of sleep per night, according to the Centers for Disease Control and Prevention.

A new Tel Aviv University study has identified the neurological mechanism responsible for disturbed emotion regulation and increased anxiety due to only one night's lack of sleep. The research reveals the changes sleep deprivation can impose on our ability to regulate emotions and allocate brain resources for cognitive processing.

The research was led by Prof. Talma Hendler of TAU's Sagol School of Neuroscience, Sackler Faculty of Medicine, and School of Psychological Sciences, and conducted by TAU graduate student Eti Ben-Simon at the Center for Brain Functions at Tel Aviv Sourasky Medical Center. It was published recently in the Journal of Neuroscience.

Nothing is neutral any more?

"Prior to our study, it was not clear what was responsible for the emotional impairments triggered by sleep loss," said Prof. Hendler. "We assumed that sleep loss would intensify the processing of emotional images and thus impede brain capacity for executive functions. We were actually surprised to find that it significantly impacts the processing of both neutral and emotionally-charged images.

"It turns out we lose our neutrality. The ability of the brain to tell what's important is compromised. It's as if suddenly everything is important," she said.

For the purpose of the study, Ben-Simon kept 18 adults awake all night to take two rounds of tests while undergoing brain mapping (fMRI and/or EEG), first following a good night's sleep and the second following a night of lack of sleep in the lab. One of the tests required participants to describe in which direction small yellow dots moved over distracting images. These images were "positively emotional" (a cat), "negatively emotional" (a mutilated body), or "neutral" (a spoon).

When participants had a good night's rest, they identified the direction of the dots hovering over the neutral images faster and more accurately, and their EEG pointed to differing neurological responses to neutral and emotional distractors. When sleep-deprived, however, participants performed badly in the cases of both the neutral and the emotional images, and their electrical brain responses, as measured by EEG, did not reflect a highly different response to the emotional images. This pointed to decreased regulatory processing.

"It could be that sleep deprivation universally impairs judgment, but it is more likely that a lack of sleep causes neutral images to provoke an emotional response," said Ben-Simon.

Losing a sense of proportion

The researchers conducted a second experiment testing concentration levels. Participants were shown neutral and emotional images while performing a task demanding their attention while ignoring distracting background pictures with emotional or neutral content — the depression of a key or button at certain moments — while inside an fMRI scanner. This time researchers measured activity levels in different parts of the brain as they completed the cognitive task.

The team found that participants after only one night of lack of sleep were distracted by every single image (neutral and emotional), while well-rested participants were only distracted by emotional images. The effect was indicated by activity change in the amygdala, a major limbic node responsible for emotional processing in the brain.

"We revealed a change in the emotional specificity of the amygdala, a region of the brain associated with detection and valuation of salient cues in our environment, in the course of a cognitive task." said Prof. Hendler.

"These results reveal that, without sleep, the mere recognition of what is an emotional and what is a neutral event is disrupted. We may experience similar emotional provocations from all incoming events, even neutral ones, and lose our ability to sort out more or less important information. This can lead to biased cognitive processing and poor judgment as well as anxiety," said Prof. Hendler.

The new findings emphasize the vital role sleep plays in maintaining good emotional balance in our life for promoting mental health. The researchers are currently examining how novel methods for sleep intervention (mostly focusing on REM sleep) may help reduce the emotional dysregulation seen in anxiety, depression, and traumatic stress disorders.

Mars Vs. Venus? Not So, Says Tel Aviv University Researcher

Prof. Daphna Joel finds brains cannot be divided into gender-based categories

Are the brains of men and women truly different? Not if you look at the overall structure, a new Tel Aviv University study says.

Some features of the brain are more common in women, some more common in men, and some are common in both. But while specific parts of the brain reveal differences based on gender, an individual brain only rarely has exclusively "male" or "female" traits, according to Prof. Daphna Joel of TAU's School of Psychological Sciences, the lead investigator of the study published on Monday by the Proceedings of the National Academy of Sciences.

Prof. Joel and her team of researchers used MRI scans of more than 1,400 brains, focusing on anatomical traits like tissue thickness or weight in different parts of the brain. They focused on those traits that showed the most obvious gender differences, dividing the scores into a predominantly male zone, a predominantly female zone, and an intermediate range.

The researchers found that individual brains rarely ended up exclusively in one of the three categories. The researchers also analyzed psychological and behavioral scores from two prior studies covering more than 5,000 participants. The results were similar.

Overall, the results show "human brains do not belong to one of [the] two distinct categories" of male and female, the researchers concluded.

For more, read the story in The New York Times, "Male vs. Female Brain? Not a Valid Distinction, Study Says."

Poor Infant Sleep May Predict Problematic Toddler Behavior

TAU study finds frequent night wakings, broken sleep patterns are linked to trouble later on

Temper tantrums and misbehavior, restlessness and inattention are the trappings of the typical toddler. But they may also be signs of developmental delays or disorders. Are infant sleep irregularities red flags for later developmental difficulties?

A study recently published in Developmental Neuropsychology finds a definite link between poor infant sleep and compromised attention and behavior at the toddler stage. The research discovered that one-year-olds who experienced fragmented sleep were more likely to have difficulties concentrating and to exhibit behavioral problems at three and four years of age.

The research was led by Prof. Avi Sadeh of Tel Aviv University's School of Psychological Sciences and conducted by a team that included his TAU colleagues Yael Guri and Prof. Yair Bar-Haim; Dr. Gali De Marcas of the Gordon College of Education in Haifa; and Prof. Andrea Berger and Dr. Liat Tikotzky of Ben Gurion University of the Negev.

A predictor of future problems

"Many parents feel that, after a night without enough sleep, their infants are not at their 'best.' But the real concern is whether infant sleep problems — i.e. fragmented sleep, frequent night wakings — indicate any future developmental problems," said Prof. Sadeh. "The fact that poor infant sleep predicts later attention and behavior irregularities has never been demonstrated before using objective measures."

The team assessed the sleep patterns of infants at TAU's Laboratory for Children's Sleep Disorders, where Prof. Sadeh is director. The initial study included 87 one-year-olds and their parents. They revisited the lab when the infants were three to four years old. According to the study, "Night-wakings of self-soothing infants go unnoticed by their parents. Therefore, objective infant sleep measures are required when assessing the role of sleep consolidation or sleep fragmentation and its potential impact on the developing child."

To accomplish this, the researchers used wristwatch-like devices to objectively determine sleep patterns at the age of one, and in the follow-up visits they used a computerized attention test, the Spatial-Stroop task, to assess attentional executive control. They also referred to parental reports to determine signs of behavioral problems.

The results revealed significant predictive and concomitant correlations between infant sleep and toddler attention regulation and behavior problems. The study points to significant ties between sleep quality markers (sleep percentage and number of night wakings) at one year of age and attention and behavior regulation markers two to three years later.

Is it genetic?

"We don't know what the underlying causes are for the lower sleep quality and later behavior regulation problems in these children," said Prof. Sadeh. "There may be genetic or environmental causes adversely affecting both the children's sleep and their development in other domains. Our findings, however, support the importance of early diagnosis and treatment of sleep problems in infants and young children. Early interventions for infant sleep problems, very effective in improving sleep quality, could potentially improve later attention and behavior regulation."

The researchers are currently exploring the underlying characteristics of children who are considered "good sleepers" at the age of nine to 18 months.

Computerized Treatment May Combat PTSD Symptoms

TAU, NIMH, and Creighton University researchers devise a computerized training program to curb debilitating syndrome for veterans

Some 10-15 percent of combat veterans struggle with wounds invisible to the naked eye: post-traumatic stress. Their lives are ridden with debilitating symptoms: insomnia, flashbacks, depression, anxiety, guilt, and ever-present tension. While there is no cure-all for post-traumatic stress disorder (PTSD), cognitive behavioral therapy — which actively reprocesses traumatic events to reduce symptoms — has seen some success.

A new study from researchers at Tel Aviv University, Creighton University in Omaha, Nebraska, and the National Institute of Mental Health suggests an entirely new approach to treating PTSD. The research discusses a cutting-edge computer program capable of alleviating PTSD symptoms by reducing fluctuations in attention toward and away from perceived threats. The research was published in the American Journal of Psychiatry and led jointly by Dr. Yair Bar Haim, head of TAU's School of Psychological Sciences and director of TAU's Laboratory for Research on Anxiety and Trauma, Dr. Daniel Pine of the NIMH Emotion and Development Branch, and Dr. Amy Badura-Black of the Department of Psychology at Creighton University.

"This approach is entirely different from existing treatments," said Dr. Bar Haim. "Our approach is bottom–up. Our targets are basic, attention-level cognitive processes. We try to normalize and regulate this behavioral system by providing very simple computer tasks, retraining the neural network to better balance threat vigilance and avoidance.

"Our results were promising," Dr. Bar Haim reported. "The program produced a significant reduction in severe PTSD symptoms, with a similar success rate as cognitive behavioral therapy."

The human threat-monitoring system

According to Dr. Bar Haim, humans have a "threat monitoring system" which fluctuates all the time, generating responses to potential threats in the environment and nullifying reactions to non-threatening stimuli.

In the computer training program, two stimuli (threatening or neutral) appear on the screen, followed by a target (an arrow) pointing left or right. The researchers hope to retrain the participant's neural network to regain the balance between threat avoidance and threat vigilance. The treatment entailed four to eight sessions of computerized training, each of which lasted 10-15 minutes.

"In PTSD, the system is in disarray, with high fluctuations — between vigilance to threats on one hand and threat avoidance on the other," said Dr. Bar Haim. "Our promising new treatment for PTSD targets a neurocognitive mechanism to mediate that system, and change attention patterns that go in disarray. If you can influence this pattern, maybe you can affect other symptoms of PTSD."

The training implicitly teaches participants that threatening stimuli are irrelevant to performing a specific task, requiring them to attend equally to threatening and neutral stimuli. The study determined that the training program reduced symptoms by reducing this variability in attention.

A safety (Inter)net for vets?

For the purpose of the study, teams of researchers from TAU and Creighton University conducted parallel trials testing the program on US and Israeli combat veterans; the results in both groups were the same.

"Our cost-effective treatment could even one day be available over the Internet," said Dr. Bar Haim. "You would need a psychologist to diagnose you and monitor your treatment, but the therapy itself could be administered over the Internet or through short visits to the clinic."

The researchers are continuing to explore the effect of the program on larger samples in Israel and in the US.

Losing Streak: Competitive High-School Sports Linked to Gambling

TAU research finds high-schoolers involved in competitive sports at higher risk of problem gambling

The soft signs of compulsive gambling — high energy levels, unreasonable expectations, extreme competitiveness, distorted optimism, and above-average IQs — are often the very traits that characterize competing athletes. However, precious little research is available on the prevalence of gambling among athletes and the relevant warning signs.

A new Tel Aviv University study published in The American Journal of Addictions indicates that high-schoolers involved in competitive sports are at an elevated risk of gambling. According to the research, led by Dr. Belle Gavriel-Fried of TAU's Bob Shapell School of Social Work and conducted by TAU student Idit Sherpsky, in collaboration with Dr. Israel Bronstein of Bar-Ilan University, the participation of male high-school students in competitive sports is associated with problem gambling and gambling frequency, and female students who participate in competitive sports are at a higher risk of gambling frequency.

"The drive to win underpins both gambling behavior and competitive sport," said Dr. Gavriel-Fried. "Most of the research within this area has been conducted on university athletes, but we wanted to dig deeper, find out whether the link between gambling and physical activities began earlier — before other co-factors emerge — and we found out that, in fact, it does."

For the study, the researchers asked 316 high-schoolers, aged 14-19, from four high schools in Israel to fill out questionnaires to establish their involvement in sports and their gambling habits. "Intensive exercise" was assessed on a frequency rating scale. "Competitiveness" was rated by the number of competitive sports engaged in over the previous year, including varsity or junior varsity sports and other extracurricular programs.

Winning vs. fitness

They found a significant difference between youths involved in intense cardiovascular activity (for the sake of exercise alone) and those participating in competitive sports. The latter were more often engaged in regulated lotteries and scratch cards, gambling on other sporting events, poker, and other card games.

"Studies conducted on college-age athletes in relation to gambling might be misleading, because the university environment itself has been found to promote risk behavior," said Dr. Gavriel-Fried. "Here we made a distinction between youths involved in competitive sport and those involved in intensive exercise. The objective of competitive sports is to win as a team, whereas the objective of intensive exercise is to maintain your health and fitness.

"There was a clear divide between the two groups. We hope that this study will redirect high schools to integrate gambling prevention programs for youths involved in competitive sports — in order to avoid sticking 'healthy heads in sick beds,' so to speak."

According to the researchers, due to their competitiveness, athletes as young as 14 should pay closer attention to the risks involved in "harmless" gambling practices, such as card games.

"For competitive athletes, there is an intrinsic impulse embedded within — to win, at all costs. This underpins gambling behavior as well," said Dr. Gavriel-Fried, who is currently researching high-risk behavior and addictions.

Personalizing Bipolar Disorder Treatment

TAU researchers find insulin-like hormone increases lithium sensitivity in patients

Rapidly swinging from extremes of joy and energy to sadness, fatigue, and confusion, bipolar disorder (BD) patients feel desperate and largely alone in the world. And according to the National Institutes of Health, between 25-50 percent of the roughly 3% of Americans living with BD attempt suicide at least once. Lithium is among the most effective therapies for BD, and remains the first-line treatment even as other mood stabilizing drugs have become available. But about half of the patients prescribed lithium do not respond to the treatment.

A new Tel Aviv University study, published in the Journal of Molecular Neuroscience, may pave the way for improving the efficacy of lithium in these patients. The study found that the insulin-like growth factor 1 (IGF-1) hormone, known for its pivotal role in tissue growth, is also capable of increasing the lithium sensitivity of blood cells in bipolar disorder patients in whom lithium was originally ineffective.

The research was led by TAU postgraduate student Dr. Elena Milanesi under the guidance of Dr. David Gurwitz of the Department of Human Molecular Genetics and Biochemistry of TAU's Sackler Faculty of Medicine and Sagol School of Neuroscience and Dr. Noam Shomron of the Department of Cell and Developmental Biology at TAU's Sackler Faculty of Medicine, in collaboration with Sackler graduate student Adva Hadar and Prof. Haim Werner of TAU's Sackler Faculty of Medicine, along with researchers in Italy and Germany.

A new hope

"Lithium has been considered the cornerstone in the management of bipolar disorder for over 50 years, even though half of patients do not sufficiently respond to chronic lithium treatment," said Dr. Gurwitz. "It is often prescribed as the first-line treatment for bipolar disorder. If it works, patients take it for years. If not, they have to explore alternatives which haven't proven as effective in long-term clinical studies."

The researchers examined the in vitro effects of insulin-like growth factor 1 (IGF-1) on lithium sensitivity in blood cell lines of both lithium-responsive and non-responsive bipolar patients. They found that when IGF-1 was added to the cultured blood cells there was increased lithium sensitivity only in the blood cells of those bipolar disorder patients who did not respond to lithium therapy.

"Our study suggests that the lack of sufficient IGF-1 activity may underlie lithium resistance in the treatment of bipolar disorder, and this hormone, or drugs mimicking or promoting its action, should be considered for improved treatment of this disorder", says Dr. Milanesi.

"There are no established animal models for bipolar disorder, so it will be hard to test this idea in animals," Dr. Gurwitz added. "However, given that IGF-1 is approved for human use in people who are deficient in this hormone, a clinical trial of IGF-1 in lithium-resistant bipolar disorder patients is warranted."

The research on lithium resistance biomarkers was supported by the U.S.-Israel Binational Science Foundation (BSF).

Shoulder to the Wheel: Parental Intervention Improves Teen Driving

TAU researcher's two-pronged strategy found to reduce risks involved in adolescent driving

Motor vehicle accidents are the leading cause of teenage death in America. According to the Centers for Disease Control and Prevention, seven 16- to 19-year-olds die every day as a result of injuries incurred from road crashes. But attempts to address the problem through legislation and technological innovation have yielded limited results.

Now a new study by TAU researchers proposes a two-pronged strategy of vigilant parental intervention and monitoring technology to improve the safety of young drivers on the road. The research, published recently in the Journal of Adolescence, was led by Prof. Haim Omer of TAU's School of Psychological Sciences and conducted by Dr. Yaara Shimshoni, in collaboration with Or Yarok of the Association for Safer Driving in Israel.

"We have shown that it is possible to reduce dangerous driving in young drivers by increasing parental involvement in a positive way," said Prof. Omer. "Our program is based on a model of parental involvement called 'Vigilant Care,' shown to be effective in reducing risky behavior exhibited in other fields. According to this model, parents remain non-invasively involved in their youngsters' activities, but are poised to increase their level of involvement at the first signs of danger."

"Vigilant Care," emphasizing both parental intervention to reduce risky behavior as well as a nurturing environment in which to introduce the involvement, lies at the heart of the model of parental guidance. Prior to the study, some parents received training in Prof. Omer's program.

Learning from feedback

For the study, 242 families of adolescent drivers installed In-Vehicle Data Recorders (IVDRs) that monitor driving in real time and offer feedback on risk patterns in the cars. The families were then assigned to one of four groups that differed according to type of IVDR feedback and level of parental intervention: 1) IVDR feedback to the entire family that led to parental intervention through their "Vigilant Care" training; 2) IVDR feedback to the entire family that did not lead to parental intervention; 3) individual IVDR feedback without parental guidance; and 4) neither IVDR feedback nor parental involvement.

For example, a young driver would be required to send a text message to his parents upon arriving at his destination and once again before midnight. In this way, the parents were certain to remain on their son's mind, one of the protective mechanisms at the heart of "Vigilant Care." The parents would also hold "driving chats" with their son on a weekly basis, sitting together to plan trips to new destinations. In these ways, the novice driver was constantly reminded of his parents while driving. As one of the teens said, "I felt as though someone was sitting by my side, even though I was alone in the car."

From pre-teens to teens

"In past studies, 'Vigilant Care' has been shown to reduce risky behavior in many areas of child development," said Prof. Omer. "However, the difficult challenge here was to amend and apply the model to an older and normative population of young adults."

After following the teen drivers and the four groups for three months at a time, the researchers found that the drivers whose parents had received "Vigilant Care" training and who had also received family-wide IVDR feedback significantly improved their behavior behind the wheel. The combined technological monitoring plus intervention was found to be most effective for drivers who exhibited the riskiest behavior.

"We have shown that the combination of technology and 'Vigilant Care' can meet the challenge of dangerous teen driving," said Dr. Shimshoni. "This is the first study in which a systematic, theory-based intervention for parental involvement in teen driving was found to be effective."

Prof. Omer, together with Or Yarok, is currently adapting and extending the "Vigilant Care" intervention to address the needs of different populations.

To Life! Practicing Judaism Could Protect Against Suicide

TAU finds secular Jewish teenagers twice as likely to have suicidal intentions as their more religious peers

In 1897, Emile Durkheim, the father of sociology, speculated that religion could protect against against suicidal impulses. In the century that followed, numerous studies attempted to either prop up or debunk this theory, focusing primarily on Christianity, which condemns suicide as the worst of sins.

For the first time, a study published in European Psychiatry approaches Durkheim's premise through the lens of Judaism. According to the research, conducted by Dr. Gal Shoval and Dr. Ben Amit of Tel Aviv University's Sackler School of Medicine and Clalit Health Service's Geha Mental Health Center, religious Jewish teens exhibit 45% less suicide-risk behavior, including attempted suicide, than their secular Jewish peers, suggesting that religious observance indeed helps protect Jewish adolescents against suicide.

"Death by suicide is one of the most common causes of death in the adolescent population, and it is potentially preventable," said Dr. Amit. "This has led us, like many other researchers, to try to better understand the reasons leading to adolescent suicide – to reduce its occurrence."

Coping and depression

In the U.S., suicide ranks behind only accidents and murder as a leading killer of 15-to-24 year-olds, according to the National Institute for Mental Health. Israel's suicide rate, on the other hand, is consistently among the lowest in the developed world.

"Using statistical tools, we demonstrated that the protective effect of the practice of Judaism was not associated with a decreased risk of depression. Instead, it enhanced effective coping mechanisms," said Dr. Amit. "This stands in direct contrast to studies of religious Christian teenagers who reported feeling less depressed than their secular peers. According to our study, religious Jewish teens appear less likely than secular ones to be at risk of suicide even though they are still likely to be depressed."

The researchers say the results could be explained by Judaism's spiritual and communal support — as well as its prohibition against suicide.

Support and insight for Jewish adolescents

The research was conducted using the Israeli Survey of Mental Health among Adolescents (ISMEHA) study from the Israeli Health Ministry. The survey consisted of home interviews of 620 Jewish adolescents (aged 14-17) and their mothers, assessing socio-demographic characteristics and mental health, including suicidal thoughts and behaviors. Participants were also asked to define their degree of religiosity as "secular," "observant," or "ultra-Orthodox," the three main categories of Judaism in Israel.

"Recognizing the risk factors and mechanisms associated with self-harm and suicide is important in the prevention of adolescent suicide. As this is the first study demonstrating a protective effect for religiosity against suicide in Jewish adolescents, we believe it may provide valuable insight for both clinicians and policymakers dealing with Jewish adolescents, in Israel and worldwide," said Dr. Amit.

According to the researchers, suicide and self-harm are highly complex behaviors which require further research to elucidate the mechanisms involved. The best way forward would combine both biological and psychological elements. "For many of these teens, suicide is simply about losing hope," said Dr. Shoval. "We know from working with suicide survivors that even when they were 99 percent sure they were going to kill themselves, they still sought hope. Jewish faith and community may be their most important source of hope."

Israeli Teens Pay a High Psychiatric Toll When Raised in Conditions of Geopolitical Conflict

Unprecedented TAU research studies mental health consequences of long-term political violence on Israeli adolescents

The latest flare-up in the Middle East catches children in the midst of their long-anticipated summer break. The wail of sirens replaces the jingle of ice cream trucks, and boys and girls dash to a bomb shelter instead of playing tag at the park. Young people are enduring a summer of violence, devastation, panic, and isolation. What are the long-term effects of these conditions?

A new study published in the Journal of Traumatic Stress by Prof. Michelle Slone of Tel Aviv University's School of Psychological Sciences and Dr. Anat Shoshani of the Interdisciplinary Center Herzliya finds that Israeli youths exposed to protracted conflict suffer far higher levels of anxiety, phobia, fear, depression, obsessive-compulsive symptoms, and paranoia than their counterparts in the U.S. The largest cross-sectional empirical study of its kind, the research assessed youths exposed to terrorism, missile attacks, war, forced residential relocations, and military operations, as well as relative quiet over an unprecedented period of 14 years.

"This was a large and logistically complicated study conducted over a long period under dynamic, violent conditions," said Prof. Slone, Director of TAU's Laboratory for Resilience in Childhood. "Whereas previous studies on conflict environments have focused on the frequency of Post Traumatic Stress Disorder and Post Traumatic Symptoms, our research pointed to varied emotional, cognitive, and behavioral symptoms, as well as a broad spectrum of clinical and sub-clinical pathologies."

Girls are at greatest risk

For the purposes of the study, annual samples from the same cities, geographical regions, and schools throughout the country were assessed for Political Life Events (PLE) exposure and for psychiatric symptoms using the Brief Symptom Inventory (BSI). Some 8,727 Jewish Israeli adolescents aged 12-17, evenly divided by gender, were assessed in eight exposure periods: pre-Intifada (1998-2000); Intifada peak (2001-2003); Intifada recession (2004); missile attacks on southern Israel and the 2006 Lebanon War (2005-2006); peak missile attacks (2006-2007); Operation Cast Lead (2008-2009); and the 9/11 period of global terrorism (2010-2011).

The research showed that, over this 14 year period, Israeli adolescents suffered from severe psychiatric symptoms and disorders. Adolescent girls reported even higher levels of psychiatric pathologies than adolescent boys, and the differential by gender increased according to direct exposure to conflict. This finding coincides with consistent findings of higher levels of pathology among girls than boys in wars and armed conflict.

"Growing up in South Africa under the Apartheid regime made me particularly sensitive to the effects of political conflict and armed conflict on children," said Prof. Slone. "Our study suggests that adolescents exposed to high levels of protracted political violence form a high-risk group for specific and non-specific pathologies."

Schools can step in

According to the researchers, insecure and conflict-ridden social environments disrupt the critical tasks normally completed during adolescence, including the establishment of personal identity and the search for both self-autonomy and a role in society. In light of her findings, Prof. Slone believes Israel's public health and education systems should address the needs of the nation's at-risk adolescent population.

"While there is no 'quick fix' for the significant psychological distress that becomes part of young people's lives in conditions of chronic violence and insecurity, a cost-effective, universal, and controlled therapeutic strategy must be implemented in schools," said Prof. Slone. "The educational system, which touches all children and adolescents across all demographic divides, stands in a unique position to institute preventive interventions that strengthen children's resilience and ability to cope with the violent environment in which they live."

Prof. Slone is currently examining the efficacy of school-based, teacher-delivered intervention programs.

No Rest for the Bleary

TAU study says parents of newborns pay a high price for their interrupted sleep

The familiar cry in the night, followed by a blind shuffle to the crib, a feeding, a diaper change, and a final retreat back into oblivion — every hour on the hour. Such is the sleep pattern of most new parents, who report feeling more exhausted in the morning than when they went to bed the night before.

Now, in the first study of its kind, Prof. Avi Sadeh and a team of researchers from Tel Aviv University's School of Psychological Sciences explain why interrupted sleep can be as physically detrimental as no sleep at all. In the study, published in the journal Sleep Medicine, Prof. Sadeh and his colleagues Michal Kahn, Shimrit Fridenson, Reut Lerer, and Yair Ben-Haim establish a causal link between interrupted sleep patterns and compromised cognitive abilities, shortened attention spans, and negative moods. The researchers discovered that interrupted sleep is equivalent to no more than four consecutive hours of sleep.

"The sleep of many parents is often disrupted by external sources such as a crying baby demanding care during the night. Doctors on call, who may receive several phone calls a night, also experience disruptions," said Prof. Sadeh. "These night wakings could be relatively short — only five to ten minutes — but they disrupt the natural sleep rhythm. The impact of such night wakings on an individual’s daytime alertness, mood, and cognitive abilities had never been studied. Our study is the first to demonstrate seriously deleterious cognitive and emotional effects."

Putting Mom and Dad in a bad mood

"In the process of advising these parents, it struck me that the role of multiple night wakings had never been systematically assessed," said Prof. Sadeh, who directs a sleep clinic at TAU, where he advises exhausted and desperate parents on how to cope with their children's persistent night wakings. "Many previous studies had shown an association, but none had established a causal link. Our study demonstrates that induced night wakings, in otherwise normal individuals, clearly lead to compromised attention and negative mood."

The study was conducted on student volunteers at TAU's School of Psychological Sciences. Their sleep patterns were monitored at home using wristwatch-like devices that detected when they were asleep and when they were awake. The students slept a normal eight-hour night, then experienced a night in which they were awakened four times by phone calls and told to complete a short computer task before going back to sleep after 10-15 minutes of wakefulness. The students were asked each following morning to complete certain computer tasks to assess alertness and attention, as well as to fill out questionnaires to determine their mood. The experiment showed a direct link between compromised attention, negative mood, and disrupted sleep — after only one night of frequent interruptions.

Paying a high price

"Our study shows the impact of only one disrupted night," said Prof. Sadeh. "But we know that these effects accumulate and therefore the functional price new parents — who awaken three to ten times a night for months on end — pay for common infant sleep disturbance is enormous. Besides the physical effects of interrupted sleep, parents often develop feelings of anger toward their infants and then feel guilty about these negative feelings.

"Sleep research has focused in the last 50 years on sleep deprivation, and practically ignored the impact of night-wakings, which is a pervasive phenomenon for people from many walks of life. I hope that our study will bring this to the attention of scientists and clinicians, who should recognize the price paid by individuals who have to endure frequent night-wakings."

Prof. Sadeh is currently researching interventions for infant sleep disturbances to reduce the detrimental effects of disrupted sleep on parents.

For a Holistic Approach to POW Trauma

TAU researcher cautions against psychological “tunnel vision” in treating prisoners of war like Sgt. Bowe Bergdahl

The full circumstances of U.S. soldier Bowe Bergdahl's captivity have yet to be revealed. During his tour of duty in Afghanistan in 2009, Bergdahl was captured by the Taliban and held in captivity for five years until a controversial prisoner exchange led to his release on May 31. Bergdahl has been accused of deserting his post and advocating the release of Afghani prisoners.

"We do know that he suffered horrific conditions, tortured and kept in a metal cage in darkness for weeks on end," said Prof. Zahava Solomon, an Israel Prize laureate, Professor of Social Work and Psychiatric Epidemiology at Tel Aviv University's School of Social Work, and head of the newly founded Center of Excellence for Mass Trauma Research, established by the Israel Science Foundation. "His identification with the enemy could be seen as a form of Stockholm Syndrome, according to which tortured individuals identify with their perpetrators and take on their beliefs as a means of survival and empowerment. In a way, it is reminiscent of victims of child abuse, who may identify with their parents and continue the cycle of abuse as adults themselves.

"On the other hand, maybe he really was a conscientious objector, as some have said, having high ideals and high morals, and he started to identify with the people he saw as victims — vulnerable locals in poor conditions," Prof. Solomon says. "It is impossible to say conclusively."

In a new study conducted with Dr. Sharon Dekel of Harvard University's Department of Psychiatry and slated for publication in the Journal of Psychiatric Research, Prof. Solomon examines the co-morbid effects of war captivity and war trauma on prisoners of war. While symptoms of psychological illness are often pigeon-holed as specific individual disorders, Prof. Solomon argues against a narrow "tunnel vision" in treating POWs such as Bergdahl, who remains in rehabilitation.

A uniquely large sample

Prof. Solomon's new study follows the progress of several hundred ex-prisoners of war captured by the Syrians and Egyptians in the 1973 Yom Kippur War, with a specific eye toward the co-morbid interplay between Post-Traumatic Stress Disorder (PTSD) and depressive symptoms. These former combat soldiers were held captive for between one and nine months, interrogated under horrific conditions, electrocuted, raped, burned with cigarettes, told Israel had been conquered, and placed in solitary confinement.

Prof. Solomon has treated the same subjects — hundreds of Israel Defense Forces soldiers captured during Israel's 1973 Yom Kippur War — over more than 40 years. The POWs, their spouses, and their children were interviewed and observed at three specific points of time (1991, 2003, 2008) over 17 years, utilizing diagnostic tools and questionnaires. Two groups of combat veterans, 275 former prisoners of war (ex-POWS) and matched combatants (controls), were assessed.

Prof. Solomon found that while depression and PTSD seem to be different long-term manifestations of traumatic stress, they are both parts of a common general traumatic stress construct. "Despite the fact that they were released 40 years ago, these men feel and behave as if they are still in captivity," said Prof. Solomon. "With PTSD, they have recurrent nightmares, are startled easily by noise, triggered by anything in the news or media reminiscent of their experiences, abusive to their spouses and children, re-enact their trauma and are overprotective. Meanwhile, they also exhibit clear depressive symptoms."

No silver bullet

Statistical analysis from the study indicated that PTSD increased in ex-POWs over time, while it remained stable among traumatized ex-combatants. The researchers observed a clear relationship between PTSD and depression, with one disorder mediating the symptoms of the other at different points in time.

"The effect of psychological trauma is like cancer — it metastasizes," said Prof. Solomon. "You cannot treat a person only according to PTSD, an anxiety disorder, or depression, an effective disorder, because then the treatment itself becomes ineffective. Sometimes they overlap, but they are also quite different. This is a major challenge for clinicians, who must not be blinded or restricted by their textbook categories. There is no silver bullet, unfortunately, but it is crucial to treat people accurately and with sensitivity, according to current knowledge, and continue the research to enable more effective treatment."

Smartphone App May Revolutionize Mental Health Treatment

New TAU technology provides professionals with immediate insight into behavioral patterns of patients

Mental illness accounts for 90 percent of all reported suicides and places the largest burden of any disease on social and economic infrastructures worldwide, according to the World Health Organization. There is a dire need for support services to assist clinicians in the evaluation and treatment of those suffering from mental illness.

New technology developed by researchers at Tel Aviv University is poised to transform the way in which patients with mental illnesses are monitored and treated by clinicians. Dr. Uri Nevo, research team engineer Keren Sela, and scientists from TAU's Faculty of Engineering and Sagol School of Neuroscience have developed a new smartphone-based system that detects changes in patients' behavioral patterns, and then transmits them to professionals in real time. It has the potential to greatly improve the response time and efficacy of clinical psychiatrists. By facilitating patient observation through smartphones, the technology also affords patients much-needed independence from hospitals, clinicians — and even family members.

Research on the application was presented in March at the Israel Society for Biological Psychiatry's annual conference. The project won funding from the Israeli Ministry of Economy and was recently chosen as one of four finalist start-up initiatives featured at Israel's leading Entrepreneurship and Innovation 8200 Accelerator Program. The team is currently in talks with other medical centers in Israel and overseas to expand clinical trials.

Using tools already "in the hand"

"The diagnosis of mental health disease is based only on behavioral patterns," said Dr. Nevo. "In some cases, a patient is discharged from the hospital into a vacuum, with no idea how to monitor his or her new state of mind. Because most people own smartphones today, we thought, 'Why not harness the smartphone, a reservoir of daily activities, to monitor behavioral patterns?'

"Bipolar disorder, for example, starts with a manic episode," said Dr. Nevo. "A patient who usually makes five or ten calls a day might suddenly start making dozens of calls a day. How much they talk, text, how many places they visit, when they go to bed and for how long — these are all indicators of mental health and provide important insights to clinicians who want to catch a disorder before it is full blown."

Researchers conducted two Helsinki-approved clinical trials with the cooperation and direction of leading psychiatrists from Geha Mental Health Center and Be'er Ya'acov Mental Health Center. In the trials, the application was installed on the smartphones of 20 patients suffering from bipolar, unipolar/depressive, or schizo-affective disorders, as well as on the phones of 20 healthy participants. Over the course of six months, the app acquired data from patients' phones and sent the information to distant computers, where advanced algorithms analyzed the data to detect changes in patients' sleep, communication, mobility, and vocal patterns. The researchers further developed a visualization system that displayed the summarized information to psychiatrists, providing them with instant insight into the behavioral trends of their patients.

Preserving patient privacy

According to Dr. Nevo, a patient using the app has full control over who has access to the behavioral patterns recorded and analyzed by it. "We take great care to protect the patient's privacy," said Dr. Nevo. "The content of calls and texts is completely ignored and never acquired or recorded, and any identifying parameters of the patient or of his contacts, are irreversibly masked and are obviously not used."

Psychiatrists in the trials reported that the system has already positively affected their interaction with patients, offering a useful objective "window" into the patient's daily routine. One patient who was involved in the clinical trial for only a brief period recently suffered a hospitalization. "If I had kept the app on my phone, you would have immediately noticed the unusual number of phone calls I was making, and this hospitalization could have been prevented," he told his psychiatrist.

"We have a way to go until such a system will be proven effective and adopted by the psychiatric community," said Dr. Nevo. "However, psychiatrists, as well as U.S. federal policymakers in the field, agree that such tools are necessary to improve psychiatric practice."

TAU and Columbia University Join Forces to Fight PTSD

Hopeful Dawn Foundation sponsors joint effort to expand research, treatment, prevention, and education

Dr. Yair Bar Haim, Professor of Psychology and Neuroscience, head of the School of Psychological Sciences, and director of the Laboratory for Research on Anxiety and Trauma at Tel Aviv University, and Dr. Yuval Neria, a decorated war veteran and Professor of Medical Psychology at Columbia University Medical Center in New York City, will collaborate through the Hopeful Dawn Foundation to create state-of-the-art programs and a center to expand the research, treatment, prevention, and education for Post Traumatic Stress Disorder (PTSD), the foundation recently announced.

Through the philanthropic support of the foundation, the new project will coordinate research activities to advance trauma related research, clinical care, and training. The collaboration will seek to develop innovative clinical interventions and prevention programs.

The announcement was made in June, which is PTSD Awareness Month.

An urgent need for research and intervention

"According to the Veterans Affairs Department, in the U.S. alone there are 22 veteran suicides per day — one every 80 minutes,” said Dr. Diana Kaplan, founder of The Hopeful Dawn Foundation. "The need for a solution is eminent, but we have yet to see a successful attempt to solve this matter.

"It is the Hopeful Dawn Foundation's mission to find a solution to this growing epidemic by creating a solution to aid the over 5.2 million veterans and civilians who have suffered trauma in the U.S. alone. Working with leading doctors in these areas while establishing programs and centers would help the suffering get the treatment they need without standing in line."

Prof. Bar-Haim, the designated director of the new Center on PTSD and Resilience at Tel Aviv University, said, "The collaborative project between Columbia University and Tel Aviv University symbolizes a Hopeful Dawn for research and clinical practice in PTSD." He added that "the new center will bring together world-renowned leaders in traumatic stress and resilience research from both universities to foster the development of cutting-edge treatments for veterans and civilians suffering from stress-related symptoms."

A much-needed nexus

The collaboration will provide a unique international forum for research to discover new knowledge related to the treatment of PTSD, establishing a base for the education of the medical and healthcare community as well as representatives of the military and political communities. In addition to the research and educational components, the center and the programs will include a multidisciplinary clinical team of psychologists, social workers, and psychiatrists.

Experts will use evidence-based and novel treatment techniques with a focus on early identification and intervention of PTSD in both Israel and the U.S. Individuals identified as suffering from the complex symptomatology of PTSD will be helped with intensive and multi-faceted treatment modalities, with the goal of preventing further deterioration and eventual recovery. It will use evidence-based and novel treatment techniques with a focus on early identification and intervention of PTSD at both locations.

The Hopeful Dawn Foundation is a charitable organization dedicated to the research, prevention, and treatment of war veterans and other young adults who suffer from trauma, severe Post Traumatic Stress Disorder, and other related psychiatric disorders. It aims to assist soldiers and civilian patients with rehabilitation and treatment in order to allow them to return to society as productive, active members of the community. Its Web site is located at http://www.hopefuldawnfoundation.org.

Making Sense of Our Senses

TAU researcher's new book reveals how sensory interaction with the world influences decisions and behavior

Book cover: SensationHave you just fallen in love? Found the perfect job? Bought a shiny new car? You might attribute these judgements and decisions to a host of considered reasons and instincts, but you might also take a closer look at the beverage you drank, the chair you sat on, and shirt you wore today.

According to a new book by Prof. Thalma Lobel, director of The Adler Center for Research in Child Development and Psychopathology at Tel Aviv University's School of Psychological Sciences, our senses influence our decisions and behavior more than we can possibly imagine. Sensation: The New Science of Physical Intelligence, published this month by Simon and Schuster, explores over 100 experiments in the modern science of embodied cognition conducted at universities around the world and concludes that sensual physical experiences unconsciously affect our everyday choices, and have profound implications for our lives.

"About five years ago, a research student of mine brought me a study conducted at Yale University," said Prof. Lobel. "The findings — that what we experience through our senses dramatically influences our decisions and behavior, without us being aware of it — were so unbelievable and surprising that I knew right then and there that this was an area I wanted to focus on in my own research."

Washing away a guilty conscience?

Prof. Lobel began conducting her own experiments in embodied cognition at TAU. In one study, Prof. Lobel examined the effect of cleanliness on cheating.

Her students approached men and women at the university gym locker room and asked them to fill out a general information questionnaire featuring some challenging, and at times unanswerable, questions. Two groups of participants — pre- and post-shower — were asked to fill out the survey. Afterwards, they were given an answer key and asked to correct their own papers, then write their final scores on a separate page — thus affording them ample opportunity to cheat.

The results of the experiment were clear: Those who showered cheated more than those still sweaty from their workout, who more often scored themselves appropriately.

"Our study confirmed that those who felt clean on the outside felt 'clean' enough on the inside to be able to falsify their test scores and report that they had correctly answered some of our impossible questions," said Prof. Lobel. "It was as if they felt a 'morality surplus' from the shower, as if they had moral character to spare and could therefore cheat."

Inner workings of the mind

While conducting her own research on the subject of physical intelligence, Prof. Lobel began examining and comparing similar studies from universities around the world. The findings — that holding a warm cup of coffee makes one friendlier, using a red typeface on tests leads to poor performance, seeing a light bulb sparks creativity, experiencing unpleasant tastes lead to harsh moral judgements, wearing sunglasses makes one likely to cheat — led to one inescapable conclusion: People are shockingly vulnerable to the influence of their senses. Temperature, texture, weight, sound, taste, smell, and color, among other physical sensations, affect people every moment of every day.

"The findings are so astonishing, remarkable in fact, that they lift the curtain on the inner workings of the mind," said Prof. Lobel. "Your sensory experience of the world influences the rational mind you believe you have, as well as the independent thoughts you believe you create."

It quickly became clear that these findings demonstrating the influence of our physical experiences on our behavior and decisions had the makings of a book. "I decided that every person should be able to read about this, not just psychology students and researchers," said Prof. Lobel. "I wanted to write a book that would not only be extremely interesting to anyone who wants to know what influences our behavior, but would also offer tools for all aspects of life — whether in business negotiations, interactions with our children and spouses, athletic performance, or dating. These tools can actually help people navigate their personal and professional lives."

Together with doctoral student Allon Cohen, Prof. Lobel is currently researching visual cues of physical stability and the association between physical and psychological stability. In another study, she is investigating the association between the color pink and optimism, reflected in such metaphors as "rose-tinted glass."

Drawing Conclusions

TAU researcher finds drawing pictures can be key tool in investigations of child abuse

Is a picture worth only a thousand words? According to Dr. Carmit Katz of Tel Aviv University's Bob Shapell School of Social Work, illustrations by children can be a critical tool in forensic investigations of child abuse.

Dr. Katz's study, published in Child Abuse and Neglect, compared the results when child abuse victims were offered the opportunity to draw during questioning with victims not offered this opportunity. Her findings saw a significant difference, suggesting a therapeutic value and indicating that children empowered to draw pictures about their abuse provided much fuller and more detailed descriptions.

"The act of drawing was not only an empowering experience for these children," said Dr. Katz. "We also found it to be forensically more effective in eliciting richer testimonies in child abuse cases. We had no idea the gap would be so great between those who drew and those who weren't given this option."

A chance to express themselves

Some 125 alleged child victims of sexual abuse were randomly selected for the field study. The children, aged 5-14, were questioned by nine well-trained forensic interviewers about a single occurrence of alleged sexual abuse. The children were divided into two sets — a control group, questioned and allowed to rest during the session; and a variable group, offered the opportunity to draw pictures about their experiences for 7-10 minutes instead of resting.

The interviews in the study were conducted according to standard NICHD (National Institute of Child Health and Human Development International Evidence-Based Investigative Interviewing of Children) protocol, which dictates using open-ended questions to elicit more comprehensive testimonies.

"For example, we asked children to 'tell me again everything that happened to you,' without using any leading terms to steer the discussion," said Dr. Katz. "And we found that if that question was followed by the comment, 'You can use the drawing if you want to,' the child's testimony was substantially more comprehensive and detailed."

In the study, Dr. Katz worked with professional practitioners from Israel's Investigative Interview Service, which is considering incorporating her strategy into the standing NICHD protocol.

Empowering the victim

"As a social worker, I'm not only interested in obtaining accurate forensic results," said Dr. Katz. "I'm also interested in empowering the children. Through drawing, children reported regaining some sense of control — even feeling hopeful. This also has recuperative properties."

Dr. Katz has focused her research on turning the typically traumatic forensic interview into a first step toward recovery for child abuse victims, who reported feeling understood, successful and in control after drawing during the questioning. "The only thing that counts is the child's narrative and his or her narrative of the respective drawing," she said. "But forensic investigators must be very careful not to attribute meaning where none exists. For example, 'I see a penis in this drawing, please tell me about it,' is a projective strategy which usually garners false results. My strategy is to offer open-ended prompts alongside drawing, which we found to be a great facilitator of communication."

Dr. Katz is currently at work on a study of younger child abuse victims, aged 3-6, who experienced multiple incidents of abuse. She hopes to see her research fully integrated into the international NICHD protocol, the prevailing approach to investigating child abuse in most countries today.

Toward a Molecular Explanation for Schizophrenia

TAU researchers find inhibition of a basic cellular process may contribute to the mysterious disease

Surprisingly little is known about schizophrenia. It was only recognized as a medical condition in the past few decades, and its exact causes remain unclear. Since there is no objective test for schizophrenia, its diagnosis is based on an assortment of reported symptoms. The standard treatment, antipsychotic medication, works less than half the time and becomes increasingly ineffective over time.

Now, Prof. Illana Gozesthe Lily and Avraham Gildor Chair for the Investigation of Growth Factors, the director of the Adams Super Center for Brain Studies at the Sackler Faculty of Medicine, and a member of the Sagol School of Neuroscience at Tel Aviv University — has discovered that an important cell-maintenance process called autophagy is reduced in the brains of schizophrenic patients. The findings, published in Nature's Molecular Psychiatry, advance the understanding of schizophrenia and could enable the development of new diagnostic tests and drug treatments for the disease.

"We discovered a new pathway that plays a part in schizophrenia," said Prof. Gozes. "By identifying and targeting the proteins known to be involved in the pathway, we may be able to diagnose and treat the disease in new and more effective ways."

Graduate students Avia Merenlender-Wagner, Anna Malishkevich, and Zeev Shemer of TAU, Prof. Brian Dean and colleagues of the University of Melbourne, and Prof. Galila Agam and Joseph Levine of Ben Gurion University of the Negev and Beer Sheva's Psychiatry Research Center and Mental Health Center collaborated on the research.

Mopping up

Autophagy is like the cell's housekeeping service, cleaning up unnecessary and dysfunctional cellular components. The process — in which a membrane engulfs and consumes the clutter — is essential to maintaining cellular health. But when autophagy is blocked, it can lead to cell death. Several studies have tentatively linked blocked autophagy to the death of brain cells seen in Alzheimer's disease.

Brain-cell death also occurs in schizophrenics, so Prof. Gozes and her colleagues set out to see if blocked autophagy could be involved in the progression of that condition as well. They found RNA evidence of decreased levels of the protein beclin 1 in the hippocampus of schizophrenia patients, a brain region central to learning and memory. Beclin 1 is central to initiating autophagy — its deficit suggests that the process is indeed blocked in schizophrenia patients. Developing drugs to boost beclin 1 levels and restart autophagy could offer a new way to treat schizophrenia, the researchers say.

"It is all about balance," said Prof Gozes. "Paucity in beclin 1 may lead to decreased autophagy and enhanced cell death. Our research suggests that normalizing beclin 1 levels in schizophrenia patients could restore balance and prevent harmful brain-cell death."

Next, the researchers looked at protein levels in the blood of schizophrenia patients. They found no difference in beclin 1 levels, suggesting that the deficit is limited to the hippocampus. But the researchers also found increased levels of another protein, activity-dependent neuroprotective protein (ADNP), discovered by Prof. Gozes and shown to be essential for brain formation and function, in the patients' white blood cells. Previous studies have shown that ADNP is also deregulated in the brains of schizophrenia patients.

The researchers think the body may boost ADNP levels to protect the brain when beclin 1 levels fall and autophagy is derailed. ADNP, then, could potentially serve as a biomarker, allowing schizophrenia to be diagnosed with a simple blood test.

An illuminating discovery

To further explore the involvement of ADNP in autophagy, the researchers ran a biochemical test on the brains of mice. The test showed that ADNP interacts with LC3, another key protein regulating autophagy — an interaction predicted by previous studies. In light of the newfound correlation between autophagy and schizophrenia, they believe that this interaction may constitute part of the mechanism by which ADNP protects the brain.

Prof. Gozes discovered ADNP in 1999 and carved a protein fragment, NAP, from it. NAP mimics the protein nerve cell protecting properties. In follow-up studies Prof. Gozes helped develop the drug candidate davunetide (NAP). In Phase II clinical trials, davunetide (NAP) improved the ability of schizophrenic patients to cope with daily life. A recent collaborative effort by Prof. Gozes and Dr. Sandra Cardoso and Dr. Raquel Esteves showed that NAP improved autophagy in cultures of brain-like cells. The current study further shows that NAP facilitates the interaction of ADNP and LC3, possibly accounting for NAP's results in schizophrenia patients. The researchers hope NAP will be just the first of their many discoveries to improve understanding and treatment of schizophrenia.

 

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