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04/01/13

Research Shows Bankruptcy Judges Influenced By Apologies

In the study, a pool of federal bankruptcy judges was presented with a hypothetical scenario: A married couple with two minor children asked the judge to approve a proposed debt repayment plan under Chapter 13 of the Bankruptcy Code. Judges were presented with a version of the facts in which the couple either did or did not offer an apology.

Debtors who apologized were seen as more remorseful and were expected to manage their finances more carefully in the future compared to debtors who did not offer an apology, according to the study, which was written by two professors of law at the University of Illinois. One of them, Jennifer K. Robbennolt, JD, PhD, is also a professor of psychology.

“Bankruptcy is different from many other areas of law because the harm is often spread across many creditors, so there is no single victim,” Robbennolt noted. “In addition, the debtor initiates the case, so the filing of a bankruptcy petition itself may be perceived as an acceptance of responsibility by the harm-doer, as a way of ‘owning up’ to an unmanageable financial condition.” 

The paper’s findings have practical implications, the authors say. “Our findings suggest that bankruptcy is, at least in part, about forgiveness, and that expectations about the rehabilitation of the debtor play a role in bankruptcy decision-making,” Robbennolt said. “Attorneys should pay attention to the ways that their bankruptcy clients can demonstrate remorse, whether that is through a formal apology or other opportunities for acknowledgement of responsibility and honest disclosure.”

Apologies also influenced judges’ assessment of whether certain discretionary expenses were “reasonably necessary,” Robbennolt said.

Source: The article, “Bankrupt Apologies,” is available online.

 

More Sleep May Reduce Depression in Teenagers

New evidence shows that inadequate sleep can lead to depression and suicidal thoughts in adolescents.

The study of nearly 16,000 teenagers in grades 7 to 12 found that adolescents with bedtimes set at midnight or later were 24 percent more likely to suffer from depression than those with bedtimes of 10 p.m. or earlier. 

Teenagers with later bedtimes also were 20 percent more likely to have suicidal thoughts.
Depression and poor sleep often go hand in hand, but sleep difficulties are usually seen as a symptom of depression, not a cause. 

The data on bedtime and depression came from a previous survey, the National Longitudinal Study of Adolescent Health, conducted between 1994 and 1996.

“Together with smaller studies that have shown sleep deprivation alters mood in teenagers, our finding is strong evidence that inadequate sleep plays a role in causing depression,” says James Gangwisch, PhD, the study’s lead author.

Moodiness from a lack of sleep may interfere with a teenager’s ability to cope with daily stress or impair relationships with friends and family. Suicidal thoughts may increase due to the effects of insufficient sleep on judgment, aggression, and impulse control.

“The biggest question I get from parents is how to get their teenagers to bed earlier,” Gangwisch says. 

“I think it’s a matter of motivating teenagers to see the benefits. In our society we think we can cut back on sleep to be more productive during the day, but the loss of concentration, energy, motivation, and now mood changes resulting from insufficient sleep can make us less productive during the day, making the extra time devoted to sleep well worth it.”

Source: The study, conducted by researchers at Columbia University Medical Center, was published in the January 2013 issue of the journal Sleep.

 

Physical and Sexual Assault Linked to Increased Suicide Risk in Military

According to results of a new study, military personnel experience increased risk of suicidal thoughts or actions if they were the victims of physical or violent sexual assault as adults. In contrast, undergraduate students experience increased risk of suicidal thoughts or actions if they were the victims of unwanted sexual experiences as children or adults.

While other research has shown that victims of sexual or physical assault are at increased risk of health problems—including suicide—the majority of that work has focused on victims sexually assaulted as children. Much less is known about the connections in a military context. This new study looked at the experiences of two groups of adults—active military personnel and young people not in active military service—and then it assessed the potential impact of various kinds of interpersonal violence on suicide risk in each.

“Suicide is a growing concern in the military, as is the issue of interpersonal assault,” says Craig Bryan, associate director of the National Center for Veterans Studies, which is based at the University of Utah, where he is also assistant professor of psychology. 

Data were collected from two sample groups—273 active duty U.S. Air Force personnel and 309 undergraduate college students—who completed surveys anonymously. Anonymity was provided to eliminate concerns about confidentiality or stigma in the military group.

Results showed that the types of assault associated with suicidal actions or behaviors in military personnel differ from those among undergraduate students. The results persist even while controlling for age, gender, relationship status, and emotional distress.

For those in the military, being a victim of rape, robbery, or violent physical assault as an adult showed a stronger relationship to actual suicide attempts than other types of assault. Physical abuse and battering as an adult were more closely linked to simply thinking about suicide. 

In contrast, for the students, unwanted sexual experiences as an adult or childhood abuse were more strongly connected with both suicide attempts and ideation than were other types of violence.

Age and marital status may account in part for the difference. The average age of those in the military group was nearly 26, and the students’ was just under 20. Further, 57 percent of the military participants were married, while 61 percent of the students were single and never married. For the military population, being somewhat older and more likely to be married, violent assaults, physical abuse, and battering may be more relevant than for the students, for whom sexual abuse is more prevalent in general.

Perhaps not surprisingly, the risk of suicidal thoughts and actions rises as the number of assaults experienced increases. This finding held true with both groups.

Source: The findings were published Jan. 18, 2013, in Suicide and Life-Threatening Behavior.

 

Job Stress Contributes to Higher Rates of Physician Suicide

Doctors who commit suicide appear to be undertreated for mental health problems, despite their seemingly good access to healthcare, a new study shows. 

Although more physicians than non-physicians in the study had known mental health problems prior to suicide, this didn’t translate into a higher rate of antidepressant use, according to the study.

The study found that physicians who committed suicide were much more likely to have potentially lethal prescription medications in their system—but not medication prescribed for depression.

Stigma, lack of confidentiality, and desire to self-treat may explain why physicians don’t seek formal treatment for mental health problems, says lead author Katherine J. Gold, MD, assistant professor of family medicine and of obstetrics and gynecology at the University of Michigan Medical School.

“I think stigma about mental health is a huge part of the story,” Gold says. “There is a belief that physicians should be able to avoid depression or just ‘get over it’ by themselves.”

Major depression is a known risk factor for suicide, particularly for female physicians. On-the-job stress could also be a bigger suicide risk factor for physicians than nonphysicians, according to the study. A physician who commits suicide is far less likely to have had the recent death of a friend or family member or a crisis, but much more likely to have a job problem. Gold says this finding suggests that a physician’s identity is strongly linked to the job role, and physicians may be particularly vulnerable to problems at work.

Source: University of Michigan Health System. “Details on suicide among U.S. physicians: data from the National Violent Death Reporting System,” 
published online January 2013.

 

Some Children Lose Autism Diagnosis

Some children who are accurately diagnosed in early childhood with autism lose the symptoms and the diagnosis as they grow older, a study supported by the National Institutes of Health has confirmed. The research team made the finding by carefully documenting a prior diagnosis of autism in a small group of school-age children and young adults with no current symptoms of the disorder.

The report is the first of a series that will probe into the nature of the change in these children’s status. Having been diagnosed at one time with an autism spectrum disorder (ASD), these young people now appear to be on par with typically developing peers. The study team is continuing to analyze data on changes in brain function in these children and whether they have subtle residual social deficits. The team is also reviewing records on the types of interventions the children received.

“Although the diagnosis of autism is not usually lost over time, the findings suggest that there is a very wide range of possible outcomes,” said NIMH Director Thomas R. Insel, MD. “Subsequent reports from this study should tell us more about the nature of autism and the role of therapy and other factors in the long term outcome for these children.”

The study recruited 34 optimal-outcome children, who had received a diagnosis of autism in early life and were now reportedly functioning no differently than their mainstream peers. For comparison, the 34 children were matched by age, sex, and nonverbal IQ with 44 children with high-functioning autism, and 34 typically developing peers. Participants ranged in age from 8 to 21 years old.

Prior studies had examined the possibility of a loss of diagnosis, but questions remained regarding the accuracy of the initial diagnosis, and whether children who ultimately appeared similar to their mainstream peers initially had a relatively mild form of autism. 

In this study, early diagnostic reports by clinicians with expertise in autism diagnosis were reviewed by the investigators. As a second step to ensure accuracy, a diagnostic expert, without knowledge of the child’s current status, reviewed reports in which the earlier diagnosis had been deleted. The results suggested that children in the optimal outcome group had milder social deficits than the high-functioning autism group in early childhood, but had other symptoms, related to communication and repetitive behavior, that were as severe as in the latter group.

The investigators evaluated the current status of the children using standard cognitive and observational tests and parent questionnaires. The optimal-outcome children had to be in regular education classrooms with no special education services aimed at autism. They now showed no signs of problems with language, face recognition, communication, and social interaction.

Source: “Optimal outcome in individuals with a history of autism.” Journal of Child Psychology and Psychiatry, first published online Jan. 16, 2013.

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