Stress and Neurotransmitters

THE SCIENCE OF PARENTING: REFERENCES CHAPTER ONE: YOUR CHILD’S BRAIN 1. “Our brains resemble old museums that contain many of the … markings of our evolutionary past, but we are able to keep much of that suppressed by our cortical lid.” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 75. 2. Sagan C (2005) Dragons of Eden: Speculations on the Evolution of Human Intelligence, Black Dog & Leventhal, New York. 3. MacLean PD (2003) The triune brain in evolution: Role in paleocerebral functions, Plenum Press, New York. 4. Sagan C (2005) Dragons of Eden: Speculations on the Evolution of Human Intelligence, Black Dog & Leventhal, New York. Eccles JC (2005) Evolution of the Brain, London, Routledge Books. 5. “There is good biological evidence for at least seven innate emotional systems ingrained within the mammalian brain. In the vernacular, they include fear, anger, sorrow, anticipatory eagerness, play, sexual lust and maternal nurturance.” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 47. “These are still the enormous forces of the deep functional architecture of the ancient brain systems. Thus fear is still fear whether in a cat or a frightened human. Rage is still rage, whether in a dog or an angry human.” Panksepp J (1998) Affective Neuroscience (op. cit.): 15. “There are seven genetically ingrained emotional circuits. They control the basic genetically encoded emotional behavioural tendencies we share with mammals … In general, both psychology and modern neuroscience have failed to give sufficient credence to the fact that organisms are born with a variety of innate affective tendencies that emerge from the ancient organizational structure of the mammalian brain.” Panksepp J (1998) Affective Neuroscience (op. cit.): 24. “These circuits have been remarkably conserved during mammalian brain evolution.” Panksepp J (1998) Affective Neuroscience (op. cit.): 203. See Jaak Panksepp’s book Affective Neuroscience (op. cit.) for a complete and detailed account of all these systems. 6. Raine A, Meloy JR, Bihrle S, Stoddard J, Lacasse L, Buchsbaum MS (1998) Reduced prefrontal and increased subcortical brain functioning assessed using positron emission tomography in predatory and affective murderers, Behavioural Sciences and the Law 16: 319-32. Dawson G, Ashman SB, Carver LJ (2000) The role of early experience in shaping behavioral and brain development and its implications for social policy, Development and Psychopathology Autumn; 12(4):695-712. A review of scientific literature on the effects of experience on early brain and behavioral development and later outcome as it pertains to risk for some forms of child psychopathology. 7. Schore A (2003) Affect Regulation and Disorders of the Self, W.W. Norton & Company, New York: 9-13. Hofer MA (1990) Early symbolic processes: Hard evidence from a soft place; in Gick RA, Bore S (Eds), Pleasure beyond the pleasure principle, Yale University Press, New Haven: 55-78. 8. Blunt Bugental D, Gabriela A, Martorella I, Barrazaa V (2003) The hormonal costs of subtle forms of infant maltreatment, Hormones and Behaviour Jan;43(1):237-44. Research showing the hormonal effects of parental responses that occur frequently but are not traditionally viewed as abusive. Gunnar MR, Donzella B (2002) Social regulation of the cortisol levels in early human development, Psychoneuroendocrinology Jan-Feb;27(1-2):199-220. Research showing that responsivity and regulation of the HPA system later in life may be shaped by social experiences during early development. Anisman H, Zaharia MD, Meaney MJ, Merali Z (1998) Do early-life events permanently alter behavioral and hormonal responses to stressors? International Journal of Developmental Neuroscience Jun-Jul;16(3-4):149-64. Research suggesting that parenting in early life can dramatically affect HPA stress response systems. 9. Beatson J, Taryan S (2003) Predisposition to depression: the role of attachment, The Australian and New Zealand Journal of Psychiatry Apr;37(2):219-25. Research showing that adverse early relational experiences can result in activation of the HPA axis, causing sensitization of depression pathways in the brain. Gordon M (2003) Roots of empathy: responsive parenting, caring societies, The Keio Journal of Medicine Dec;52(4):236-43. Research showing that during the period of rapid brain development, adversity has a devastating impact on the baby’s developing brain. Repeated experiences of stress are hardwired into the brain, creating damaging pathways. The parent is the baby’s lifeline, mitigating stress for him and helping him to learn to regulate his emotions. de Kloet ER, Sibug RM, Helmerhorst FM, Schmidt M (2005) Stress, genes and the mechanism of programming the brain for later life, Neuroscience and Biobehavioral Reviews Apr;29(2):271-81. Research showing that adverse conditions during early life are a risk factor for stress-related diseases such as depression and post-traumatic stress disorder (PTSD). Cole PM, Michel MK, Teti LO (1994) The development of emotion regulation and dysregulation: a clinical perspective, Monographs of the Society for Research in Child Development 59(2-3):73-100. Research showing that the emotional conditions of early childhood appear to be very important in optimizing or interfering with how the child’s emotionality regulates his or her interpersonal and intrapsychic functioning and how the child learns to regulate emotion. If a dysregulatory pattern becomes stabilized and part of the emotional repertoire, it is likely that this pattern is a symptom and supports other symptoms. McEwen BS (2003) Early life influences on life-long patterns of behavior and health, Mental Retardation and Developmental Disabilities Research Reviews 9(3):149-54. Research showing that early life experiences have profound effects on a child’s physical and mental health. Unstable parent-child relationships can lead to behavioral disorders and increased mortality and morbidity in later life. One common consequence, namely, depressive illness, is associated with chemical imbalances in the brain and hormonal dysregulation. 10. Hariri AR, Bookheimer SY, Mazziotta JC (2000) Modulating emotional responses: effects of a neocortical network on the limbic system, Neuroreport Jan 17;11(1):43-48. Research demonstrating how stress regulation through verbal reflection, and helping children find words for feelings, can modulate and control primitive feelings, and diminish activation in the amygdala. Barbas H, Saha S, Rempel-Clower N, Ghashghaei T (2003) Serial pathways from primate prefrontal cortex to autonomic areas may influence emotional expression, Neuroscience Oct 10;4(1):25. Research demonstrating top-down pathways in the brain, from frontal lobes to the subcortical area (including hypothalamus, amygdala, and brain stem). These pathways show the rapid influence of the prefrontal cortex on the autonomic system in processes underlying the appreciation and expression of emotions. 11. Davidson RJ, Putnam KM, Larson CL (2000) Dysfunction in the neural circuitry of emotion regulation – a possible prelude to violence, Science Jul 28;289(5479):591-94. Research showing that emotion is regulated in the brain by complex systems including the orbitofrontal cortex. Impulsive aggressive behaviour arises as a consequence of faulty emotional regulation. Davidson RJ, Slagter HA (2000) Probing emotion in the developing brain: functional neuroimaging in the assessment of the neural substrates of emotion in normal and disordered children and adolescents, Mental Retardation and Developmental Disabilities Research Reviews 2000;6(3):166-70. Research showing that virtually all mental illness involves some dysregulation of emotion. Moreover, many psychiatric disorders with adult onset have early subclinical manifestations in children. “One can ask whether the downward cognitive controls or the upward emotional controls are stronger. If one looks at the question anatomically and neurochemically, the evidence seems overwhelming. The upward controls are more abundant and electrophysiologically more insistent; hence one might expect that they would prevail if push came to shove.” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 319. 12. “As the cortex develops, vast numbers of top down neural networks connect with the subcortical area. These top down networks provide the information pathway for inhibiting reflexes and bringing subcortical functions under cortical control. Thus, a vital aspect of the development of the cortex is … inhibitory.” Cozolino L J (2002) The Neuroscience of Psychotherapy: Building and Rebuilding the Human Remain, W.W. Norton & Company, London. “The goal of cognitive processes is to provide more subtle solutions to problems posed by states of emotional arousal.” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 319. Lacroix L, Spinelli S, Heidbreder CA, Feldon J (2000) Differential role of the medial and lateral prefrontal cortices in fear and anxiety, Behavioral Neuroscience Dec;114(6):1119-30. Research showing the role of the PFC in mediating or modulating central states of fear and anxiety. 13. Ito M, Wako Saitama, No To Hattatsu (2003) Why “Nurturing the brain” now? Brain Science Institute Mar;35(2):117-20. Research demonstrating that new knowledge of the brain will help us in choosing an appropriate timing for childcare and education on the basis of new knowledge about the critical period of development for various brain functions. Rosenfeld P, Gutierrez YA, Martin AM, Mallett HA, Alleva E, Levine S (1991) Maternal regulation of the adrenocortical response in preweanling rats, Physiology & Behavior Oct;50(4):661-71. Research demonstrating that maternal regulation is involved in the regulation of the responsiveness of the infant’s HPA system. 14. Bowlby J (1973) Attachment and Loss: Volume 2 – Separation, Anxiety and Anger, Hogarth Press, London. 15. Sanchez MM, Ladd CO, Plotsky PM (2001) Early adverse experience as a developmental risk factor for later psychopathology, Development and Psychopathology Summer;13(3):419-49. The interaction of childhood stress may increase an individual’s emotional distress in later life, causing problems such as anxiety and mood disorders. The early environment appears to programme some aspects of neurobiological development and, in turn, behavioural, emotional, cognitive, and physiological development. Preston SD, de Waal FB (2002) Empathy: its ultimate and proximate bases, The Behavioral and Brain Sciences Feb;25(1):1-20; discussion 20-71. Research showing that over-activation of stress response systems, a reaction that may be necessary for short-term survival, increases the risk for obesity, diabetes, and hypertension; a host of psychiatric problems; and heightened risk of suicide. It also accelerates the aging and degeneration of brain structures. Field T (1994) The effects of mother’s physical and emotional unavailability on emotion regulation, Monographs of the Society for Research in Child Development 59;(2-3):208-27. Research demonstrating that physical and emotional unavailability from the mother (as in maternal depression) caused problems with cortisol levels, sleep, eating, toileting, and the immune system. The unavailability meant that the child was deprived of a regulator of stimulation (the mother). This lead to a lack of organized physiological rhythm in the child. CHAPTER TWO: CRYING & SEPARATIONS 1. Panksepp J, Herman B, Conner R, Bishop P, Scot JP (1978) The biology of social attachments: opiates alleviate separation distress, Biological Psychiatry Oct;13:607-18. Research showing that if a puppy is taken away from his mother, he can cry 700 times in 15 minutes. 2. Kitzinger S (2005) Understanding your Crying Baby, Carroll & Brown, London. See this excellent book on crying, with extensive research studies on mothers’ feelings about crying babies, and personal and relationship factors for the mother that influence a baby’s crying. 3. Leach P (2003) Your Baby & Child, Dorling Kindersley, London: 273. 4. Dawson G, Ashman SB, Carver LJ (2000) The role of early experience in shaping behavioural and brain development and its implications for social policy, Developmental Psychology Autumn;12(4):695-712. Research showing that the early postnatal period is a very sensitive period with respect to the effects of stress on the developing nervous system. Gunnar MR (1989) Studies of the human infant’s adrenocortical response to potentially stressful events, New Directions for Child Development Fall:3-18. Research showing that cortisol levels can go up in response to minor stimuli such as undressing and weighing. In periods of quiet and silence the baby can also be suffering from stress, with higher elevations in cortisol than in crying (hence “silent crying”). Plotsky PM, Thrivikraman KV, Meaney MJ (1993) Central and feedback regulation of hypothalamic corticotrophin-releasing factor secretion, Ciba Foundation Symposium: 59-75. Research showing how stress in early life can have a lasting influence on the HPA axis, a key stress-regulating system in the brain. Bremner JD, Vythilingam M, Anderson G, Vermetten E, McGlashan T, Heninger G, Rasmusson A, Southwich SM, Charney DS (2003) Preclinical studies showed that early stress results in long-term alterations in the hypothalamic-pituitary-adrenal (HPA) axis, Biological Psychiatry Oct 1: 710-18. Research showing that stress in early life can result in long-term alterations to the HPA axis, a key stress-regulating system in the brain. 5. Gunnar MR, Donzella B (2002) Social regulation of the cortisol levels in early human development, Psychoneuroendocrinology Jan-Feb: 199-220. Research showing the sensitivity of cortisol activity associated with variations in maternal care. Ashman SB, Dawson G, Panagiotides H, Yamada E, Wilkinson CW (2002) Stress hormone levels of children of depressed mothers, Development and Psychopathology Spring: 333-49. Research suggesting that disruptions in early care can have long-term effects on the hypothalamic-pituitary-adrenal (HPA) axis, which mediates the stress response. Blunt Bugental D, Martorella GA, Barrazaa V (2003) The hormonal costs of subtle forms of infant maltreatment, Hormones and Behaviour Jan: 237-44. Research showing higher baseline levels of cortisol, and disruptions to the normative functioning of the HPA axis, in children whose mothers used withdrawal to change the infant’s behaviour. Vazquez DM, Eskandari R, Phelka A, Lopez JF (2003) Impact of maternal deprivation on brain corticotropin-releasing hormone circuits: prevention of CRH receptor-2 mRNA changes by desipramine treatment, Neuropsychopharmacology May: 898-909. Research showing that maternal deprivation can alter the brain’s pituitary-adrenal system. 6. Zubieta JK, Ketter TA, Bueller JA, Xu Y, Kilbourn MR, Young EA, Koeppe RA (2003) Regulation of human affective responses by anterior cingulate and limbic and m-opioid neurotransmission, General Psychiatry Nov 60(11):1037-1172. Research showing that sustained sadness is associated with deactivation of m-opioid neurotransmission in the anterior cingulate gyrus, the amgydala, and the temporal cortex. This correlates to increases in negative feelings and reduction in positive feelings. The opioid system is involved in the physiological regulation of affective states and regulation of emotional pain; therefore, opioid withdrawal may lead to fear, stress, and emotional pain. “The premise will be that when we nurture our children well, they have a secure base because their brain chemicals evoke the comfortable feeling that everything is all right. When children are neglected, other chemical patterns prevail in their brains. The latter patterns do not promote confidence and social efficacy but rather motivate behaviours based on persistent feelings of resentment and emotional distress. If these feelings prevail for too long, depression emerges, personality changes may occur, and the most sensitiveindividuals may be psychologically scarred for life.” Panksepp J (1998) Affective Neuroscience, Oxford University Press, New York: 250. 7. Eisenberger NI, Lieberman MD, Williams KD (2003) Does rejection hurt? An FMRI study of social exclusion, Science Oct: 290-92. Research showing how separation distress activates the parts of the brain that register physical pain, and that psychological pain parallels physical pain. Panksepp J (2003) Neuroscience: feeling the pain of social loss, Science Oct 10;302(5643):237-39. 8. Gerhardt S (2004) Why love matters: how affection shapes a baby’s brain, Brunner-Routledge, Kings Lynn, UK. See this book for a thorough collation of the research on the relationship between early stress in childhood and an oversensitive hypothalamic-pituitary-adrenal (HPA) axis, which can result in vulnerability to depression, anxiety disorders, or problems with anger in later life. 9. Heim C, Owens MJ, Plotsky PM, Nemeroff CB (1997) Persistent changes in corticotropin-releasing factor systems due to early life stress: relationship to the pathophysiology of major depression and post-traumatic stress disorder, Psychopharmacology Bulletin: 185-92. Research showing how early life stress can result in enduring alterations to key stress systems in the brain, making the child far more vulnerable to the adverse effects of stress in later life. Beatson J, Taryan S (2003) Predispositions to depression: the role of attachment, The Australian and New Zealand Journal of Psychiatry Apr: 219-25. Research showing that adverse early relational experiences causing activation of the hypothalamic-pituitary-adrenal (HPA) axis, during critical early stages of development, can predispose a child to depression in later life after an adverse life event. Plotsky PM, Owens MJ, Nemeroff CB (1998) Psychoneuroendocrinology of depression. Hypothalamic-pituitary-adrenal axis, The Psychiatric Clinics of North America June: 293-307. Research showing the dysfunction of the HPA axis in depression – a dysfunction often hardwired by early childhood relational stress or being left alone too long. Luby JL, Heffelfinger A, Mrakotsky C, Brown K, Hessler M, Spitznagel E (2003) Alterations in stress cortisol reactivity in depressed preschoolers relative to psychiatric and no-disorder comparison groups, Archives of General Psychiatry Dec: 1248-1555. Research showing that depressed preschoolers displayed increased cortisol levels in response to both separation and frustration stressors. These findings provide evidence for possible continuation of HPA axis alterations in depressive disorders across the lifespan. Charmandari E, Kino T, Souvatzoglou E, Chrousos GP (2003) Pediatric stress: hormonal mediators and human development, Hormone Research: 161-79. Research showing that stress in early life can account for a number of glandular, metabolic, autonomic and psychiatric disorders. Coplan JD, Andrews MW, Rosenblum LA, Owens MJ, Friedman S, Gorman JM, Nemeroff CB (1996) Persistent elevations of cerebrospinal fluid concentrations of cortiocotrophin-releasing factor in adult nonhuman primates exposed to early-life stressors: implications for the pathophysiology of mood and anxiety disorders, Proceedings of the National Academy of Sciences of the United States of America, Feb 20: 1619-23. Research showing that stress in early childhood can lead to mood and anxiety disorders in later life through persistent over-activity of neurons containing corticotropin-releasing factor (CRF). Owens MJ, Plotsky PM, Nemeroff CB (1999) The role of corticotrophin-releasing factor in depression and anxiety disorders, The Journal of Endocrinology Jan: 1-12. Research showing how early life stress can cause hyper-activation of a very powerful hormone called corticotropin-releasing factor (CRF). This increase in CRF is believed to mediate symptoms of depression. Gunnar MR, Donzella B (2002) Social regulation of the cortisol levels in early human development, Psychoneuroendocrinology Jan-Feb: 199-220. Research showing that responsivity and regulation of the hypothalamic-pituitary-adrenal (HPA) axis later in life may be shaped by social experiences during early development and variations in quality of care among infants and toddlers. 10. McEwen BS, Milliken H and M (1999) Stress and the aging hippocampus, Neuroendocrinology Jan: 49-70. Research showing that early experience can determine individual differences in brain and body aging by setting the reactivity of the HPA axis. Bremner JD, Narayan M (1998) The effects of stress on memory and the hippocampus throughout the life cycle: implications for childhood development and aging, Developmental Psychology Fall;10(4):871-85. Research showing that stress causes cell death in the hippocampus, which can be seen as a form of accelerated aging. Moghaddam B, Bolinao ML, Stein-Behens B, Sapolsky R (1994) Glucocorticoids mediate the stress-induced extracelluar accumulation of glutamate, Brain Research 655: 251-254. Research showing hippocampal damage caused by stress. 11. Bremner JD (2003) Long-term effects of childhood abuse on brain and neurobiology, Child and Adolescent Psychiatric Clinics of North America Apr: 271-92. Research showing that stress in early childhood is associated with long-term alterations in brain circuits and systems that mediate the stress response, altering brain functions in several regions including the hippocampus and amygdala. In addition, early stress can adversely affect benzodiazepine, opiate, and dopaminergic systems in the brain. Rosenblum LA, Coplan JD, Friedman S, Bassoff T, Gorman JM, Andrews MW (1994) Adverse early experiences affect noradrenergic and serotonergic functioning in adult primates, Biological Psychiatry Feb 15: 221-27. Research showing that stress in early life may play a role in determining subsequent susceptibility to adult anxiety and affective disorders, and that this relationship may be the result of altered neurodevelopment of the noradrenergic and/or serotonergic systems. Herlenius E, Lagercrantz H (2001) Neurotransmitters and neuromodulators during early human development, Early Human Development Oct: 21-37. Research showing that at birth there is a surge of neurotransmitters such as catecholamines, which may be important for neonatal adaptation and for the development of the neuronal circuits. Prenatal and neonatal stress may disturb the wiring and cause long-term behavioural effects (neonatal programming). Caldji C, Diorio J, Meaney MJ (2000) Variations in maternal care in infancy regulate the development of stress reactivity, Biological Psychiatry Dec 15: 1164-74. Research showing that lots of maternal physical comfort in early life can enable primates to deal well with stress in later life and be less aggressive, whereas lack of physical comfort in early life can activate stress. Primates deprived of mother’s contact had chronically low levels of dopamine and adrenaline activity and then overly high levels of dopamine and adrenaline when stressed. They also had a poor ability to cope with common social stressors in later life. On reaching motherhood, they were more likely to reject and abuse their own infants. Kaufman J, Plotsky PM, Nemeroff CB, Charney DS (2000) Effects of early adverse experiences on brain structure and function: clinical implications, Biological Psychiatry Oct 15: 778-90. Early life stress is linked to major depression and psychiatric disorders in adulthood, due to alterations in the gamma-aminobutyric acid (GABA) and benzodiazepine systems, corticotropin-releasing hormone (CRH) system, and monoamine systems (serotonin and adrenaline). However, the quality of the care-giving environment can moderate these effects. Stress has also been shown to promote structural and functional alterations in brain regions similar to those seen in adults with depression. Pruessner JC, Champagne F, Meaney MJ, Dagher A (2004) Dopamine release in response to a psychological stress in humans and its relationship to early life maternal care: a positron emission tomography study using [11C]Raclopride, Journal of Neuroscience Mar 17: 2825-31. Research finding that disruptions of the mother-infant relationship can have long-lasting effects on the mesolimbic dopamine system and the hypothalamic-pituitary-adrenal (HPA) axis. Gardner KL, Thrivikraman KV, Lightman SL, Plotsky PM, Lowry CA (2005) Early life experience alters behavior during social defeat: Focus on serotonergic systems, Neuroscience Sep. 21: 181-91. Social defeat in early life is linked to alterations in serotonin system. 12. Zubieta JK, Ketter TA, Bueller JA, Xu Y, Kilbourn MR, Young EA, Koeppe RA (2003) Regulation of human affective responses by anterior cingulate and limbic and m-opioid neurotransmission, General Psychiatry Nov;60(11):1037-1172. Research showing that sustained sadness is associated with deactivation of m-opioid neurotransmission in the anterior cingulate gyrus and in the amgydala and temporal cortex. This correlates to increases in negative feelings and a reduction in positive feelings. 13. Ludington-Hoe SM, Cong X, Hashemi F (2002) Infant crying: nature, physiologic consequences, and select interventions, Neonatal Network Mar 21: 29-36. Research showing that immediate and long-term consequences of infant crying include increased heart rate and blood pressure, reduced oxygen level, elevated cerebral blood pressure, and initiation of the stress response. Caregivers are encouraged to answer infant cries swiftly, consistently, and comprehensively. Bergman N (2005) More than a cuddle: skin-to-skin contact is key, The Practising Midwife Oct;8(9):44. “Bergman’s extensive research shows that when the baby is separated from its mother, there can be a ten-fold increase in stress hormones. Such levels are neurotoxic. (Modi and Glover 1998.) Removed from their correct habitat (the mother’s body) all infant mammals exhibit an identical pre-programmed response referred to as the ‘protest-despair’ response. (Alberts 1994.) The protest response is one of intense activity seeking reuniting with the mother, the despair response is a withdrawal and survival response mediated by a massive rise in stress hormones. Separation stress also has powerful inhibitory effects on all gastrointestinal functions. Somatostatin is released depressing all beneficial hormones in the baby’s gut as well as growth hormone. (Uvnas-Moberg 1989.) There are also major fluctuations in breathing, temperature, and heart rate.” 14. Ribble M (1998) Disorganising factors of infant personality, Americal Journal of Psychiatry: 459-63. Touch of the mother has definite biological implications in the regulation of breathing and nutritive functions in the child. Uvnas-Moberg K (1998) Oxytocin may mediate the benefits of positive social interaction and emotions, Psychoneuroendocrinology Nov: 819-35. Research showing that touch can have potent physiological anti-stress effects. Blood pressure goes down, cortisol is decreased, and insulin and cholecystokinin levels are increased. After repeated oxytocin treatment, the healing rate of wounds increased. So oxytocin has very special properties. Haley DW, Stansbury K (2003) Infant stress and parent responsiveness: regulation of physiology and behavior during still-face and reunion, Child Development Sep-Oct: 1534-46. Research showing that emotionally responsive parents can regulate a child’s heart rate. Thus there are very important links between behaviour and infant stress reactivity and regulation. Michelsson K, Christensson K, Rothganger H, Winberg J (1996) Crying in separated and non-separated newborns: sound spectrographic analysis, Acta Paediatrica Apr: 471-75. Research showing that 1 to 2 hours after birth babies separated from their mothers cried, and the crying stopped when they were reunited with their mothers. Rosenfeld P, Gutierrez YA, Martin AM, Mallett HA, Alleva E, Levine S (1991) Maternal regulation of the adrenocortical response in preweanling rats, Physiology & Behavior Oct: 661-71. Research showing that mother-child interaction is involved in the regulation of the responsiveness of the infant’s hypothalamic-pituitary-adrenal (HPA) system. Christensson K, Cabrera T, Christensson E, Uvnas-Moberg K, Winberg J (1995) Separation distress call in the human neonate in the absence of maternal body contact, Acta Paediatrica May: 468-73. Research showing that newborns will cry as a result of physical separation from mothers. Crying stops at reunion. Crying in mammalian species serves to restore proximity to the mother. The findings are compatible with the opinion that the most appropriate position of the healthy full-term newborn baby after birth is in close body contact with the mother. Panksepp J, Herman B, Conner R, Bishop P, Scot JP (1978) The biology of social attachments: opiates alleviate separation distress, Biological Psychiatry Oct: 607-18. Research showing that low doses of opioids profoundly reduce crying due to brief periods of social isolation. (The baby’s parent-figures can activate these same natural opioids in the baby’s brain.) 15. Caldji C, Francis D, Sharma S, Plotsky PM, Meaney MJ (2000) The effects of early rearing environment on the development of GABAA and central benzodiazepine receptor levels and novelty-induced fearfulness in the rat, Neuropsychopharmacology Mar: 219-29. Research with other mammals shows how the development of the GABA system in the brain can be altered by early life stress, particularly in relation to maternal behaviour, leading to fearfulness in adulthood. Studies in humans support the idea that alterations in the GABAA / BZ receptor complex might form the basis of a vulnerability to anxiety disorders. Hsu FC, Zhang GJ, Raol YS, Valentino RJ, Coulter DA, Brooks-Kayal AR (2003) Repeated neonatal handling with maternal separation permanently alters hippocampal GABAA receptors and behavioural stress responses, Proceedings of the National Academy of Sciences of the United States of America Oct 14: 12213-18. Research showing that separation from the mother in early life can produce long-term changes in the GABA chemical system in the brain. The GABA system is very sensitive to a stressful early environment. 16. Graham YP, Heim C, Goodman SH, Miller AH, Nemeroff CB (1999) The effects of neonatal stress on brain development: implications for psychopathology, Development and Psychopathology Summer: 545-65. Early life stress can lead to vulnerability to stress-related psychiatric disorders in later life, due to changes in the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis. Habib KE, Gold PW, Chrousos GP (2001) Neuroendocrinology of stress, Endocrinology and Metabolism Clinics of North America Sep: 695-728; vii-viii. Research showing that when something is seen as threatening or extreme there is ANS arousal and HPA response, as well as activation of the amgydala and locus coeruleus (noradrenaline system in the brain stem). Levenson RW (2003) Blood, sweat, and fears – the architecture of emotion, Annals of the New York Academy of Sciences 1000:348-66. Research showing that the ANS is key in the regulation of breathing, digestion, and the endocrine system. Porges SW, Bazhenova OV (1997) Evolution and the autonomic nervous system: a neurobiological model of socio-emotional and communication disorders. Research showing cortical control of the viscera via neural pathways from the frontal lobe to the brain stem, when the environment is perceived as safe. When we feel unsafe we move into fight/flight behaviours. 17. Field T (1994) The effects of mother’s physical and emotional unavailability on emotion regulation, Monographs of the Society for Research in Child Development 59;(2-3):208-27. Research showing that physical or emotional unavailability of the mother caused problems for the child in terms of cortisol levels, sleep, eating, toileting, and the immune system. The unavailability meant that the child was deprived of vital emotional and physiological regulation. Siniatchkin M, Kirsch E, Arslan S, Stegemann S, Gerber WD, Stephani U (2003) Migraine and asthma in childhood: evidence for specific asymmetric parent-child interactions in migraine and asthma families, Cephalalgia Oct;23(8):790-802. Research showing a connection between migraine in childhood and directive dominant parent interactions. In families where a child suffered from asthma, parent-child interactions were also more conflicting and less cooperative. Donzella B, Gunnar MR, Krueger WK, Alwin J (2000) Cortisol and vagal tone responses to competitive challenge in preschoolers: associations with temperament, Developmental Psychobiology Dec;37(4):209-20. Research showing that tense/angry children (aged 3-5 years) showed decreased vagal tone in competitive situations. Bracha HS (2004) Can premorbid episodes of diminished vagal tone be detected via histological markers in patients with PTSD, International Journal of Psychophysiology Jan;51(2):127-33. Research on heart rate variability suggests that early life episodes of diminished vagal tone may predict poor stress resilience in adults. Research looked at diminished vagal tone episodes experienced prior to age 10. Cookson W (1999) Asthma, eczema and hayfever: the alliance of genes and environment in asthma and allergy, Nature Nov 25;402(6760 Suppl):B5-11. Research showing that asthma, eczema, and hayfever are complex interactions between largely unknown genetic and environmental mechanisms. However, early life seems very important, when the initiation of allergic disease may result from genetic and environmental modification of the immune interaction between mother and child. Watkins LL, Grossman P, Krishnan R, Sherwood A (1999) Anxiety and vagal control of heart rate, Psychosomatic Medicine Jul-Aug;60(4):498-502.Highly anxious personality was associated with significantly reduced vagal control of the heart. 18. Stam R, Akkermans LM, Wiegant VM (1997) Trauma and the gut: interactions between stressful experience and intestinal function, Gut 40: 704-09. Research showing a strong association between gastrointestinal disorders and being hit in childhood. Alfven G (2004) Plasma oxytocin in children with recurrent abdominal pain, Journal of Pediatric Gastroenterology and Nutrition May;38(5):513-17. Research showing that oxytocin levels are lower in children and adults with recurrent abdominal pain of psychosomatic origin and children with irritable bowel syndrome. Jarrett ME, Burr RL, Cain KC, Hertig V, Weisman P, Heitkemper MM (2003) Anxiety and depression are related to autonomic nervous system function in women with irritable bowel syndrome, Digestive Diseases and Sciences Feb;48(2):386-94. Mayer EA, Naliboff BD, Chang L, Coutinho SV (2001) Stress and the Gastrointestinal Tract V: stress and irritable bowel syndrome, American Journal of Physiology: Gastrointestinal and Liver Physiology Apr 280 (4). Research showing that psychological stressors have physiological effects particularly on gut function and brain-gut interactions. Early life stress (loss, neglect, parental stress, etc.) plays a major role in the vulnerability of individuals to develop functional gastrointestinal (GI) disorders later in life. “In a recent survey, a regular once or twice a day habit was enjoyed by less than half the men and barely a third of the women.” Heaton K (1999) Your Bowels, British Medical Association / Dorling Kindersley, London: 34. 19. Kramer KM, Cushing BS, Carter CS (2003) Developmental effects of oxytocin on stress response: single versus repeated exposure, Physiology & Behavior Sept;79(4-5):775-82. Research showing that oxytocin (OT) is associated with an attenuated stress response. Increased levels of OT in the early postnatal period have been shown to affect behaviour and physiology and these effects last into adulthood, suggesting an organizational role for OT during development. Carter CS (2003) Developmental consequences of oxytocin, Physiology & Behavior Aug;79(3):383-97. Research showing how oxytocin (OT) is capable of moderating behavioural responses to various stressors as well as reactivity in the hypothalamic-pituitary-adrenal (HPA) axis, a key stress response system in the brain. Liu D, Diorio J, Tannenbaum B, Caldji C, Francis D, Freedman A, Sharma S, Pearson D, Plotsky PM, Meaney MJ (1997) Maternal care, hippocampal glucocorticoid receptors, and hypothalamic-pituitary-adrenal responses to stress, Science Sept 12;277(5332):1659-62. Research showing that high levels of touch in childhood resulted in improved responses to acute stress and lower levels of stress chemicals in later life. Panksepp J, Herman B, Conner R, Bishop P, Scot JP (1978) The biology of social attachments: opiates alleviate separation distress, Biological Psychiatry Oct;13(5):607-18. Research showing that low doses of opioids could profoundly reduce crying resulting from brief periods of social isolation. Flemming AS, O’Day DH, Kraemer GW (1999) Neurobiology of mother–infant interactions; experience and central nervous system plasticity across development and generations, Neuroscience and Biobehavioral Reviews May: 673-85. Research with other mammals showing that high levels of touch in infancy positively affect the child’s capacity to handle stress well in adulthood. This is due to long-term changes in brain mechanisms that modulate stress reactivity. 20. Jackson D (2004) When Your Baby Cries, Hodder-Mobius, London: 99. 21. Murray L, Andrews L (2000) The social baby: Understanding babies’ communication from birth, CP Publishing, Richmond, Surrey, UK. 22. Cacioppo JT, Hawkley LC, Crawford LE, Ernst JM, Burleson MH, Kowalewski RB, Malarkey WB, Van Cauter E, Berntson CG (2002) Loneliness and health: potential mechanisms, Psychosomatic Medicine May-June: 407-17. Research showing that loneliness impacts on a person’s bodily systems, causing higher heart rate, poorer sleep, and high blood pressure. This raises concerns regarding loneliness and pre-disease mechanisms that warrant special attention. 23. Panksepp J (2003) Neuroscience: feeling the pain of social loss, Science Oct 10;302(5643):237-39. 24. Caldji C, Diorio J, Meaney MJ (2003) Variations in maternal care alter GABAA receptor subunit expression in brain regions associated with fear, Neuropsychopharmacology 28, 1950-59. 25. Chugani HT, Behen ME, Muzik O, Juhasz C, Nagy F, Chugani DC (2001) Local brain functional activity following early deprivation: a study of postinstitutionalized Romanian orphans, Neuroimage Dec: 1290-1301. Research on brain impairment in children brought up in orphanages, with too little adult-child interaction and emotional regulation. 26. Paul J, Kuhn CM, Field TM, Schanberg SM (1986) Positive effects of tactile versus kinaesthetic or vestibular stimulation on neuroendocrine and ODC activity in maternally deprived rat pups, Life Science: 2081-87. Research with other mammals showing that even short-term separation in early life can produce adverse effects in the brain, increasing levels of stress hormones. Sanchez MM, Ladd CO, Plotsky PM (2001) Early adverse experience as a developmental risk factor for later psychopathology: evidence from rodent and primate models, Development and Psychopathology Summer: 419-49. Research showing that experiences of separation and loss in early life are associated with long term changes in the brain’s stress response systems. Kuhn CM, Schanberg SM (1998) Responses to maternal separation: mechanisms and mediators, International Journal of Developmental Neuroscience Jun-Jul: 261-70. Research showing that the consequences of disrupting mother-infant interactions range from marked suppression of certain neuroendocrine and physiological systems, after short periods of maternal deprivation, to retardation of growth and behavioural development, after chronic periods. Separation initiates a complex adaptive biobehavioural response including a decrease in enzymes vital for normal cell growth and development, suppression of cell responses to growth hormone, and abnormal patterns of neuroendocrine secretion. This unique pattern of adaptation to maternal separation is not related to food or temperature changes but results largely from a lack of touch. Hennessy MB (1997) Hypothalamic-pituitary-adrenal responses to brief social separation, Neuroscience and Biobehavioral Reviews Jan: 11-29. Separation from those to whom we are emotionally attached leads to an immediate and persistent HPA response, whereas separation of partners that are affiliative but do not exhibit attachment has little or no effect on HPA activity. 27. Robertson J, Robertson J (1969) “John – 17 Months: Nine Days in a Residential Nursery”, 16mm film/video: The Robertson Centre. Accompanied by a printed “Guide to the Film” series. British Medical Association / Concord Film Council. 28. Ahnert L, Gunnar MR, Lamb ME, Barthel M (2004) Transition to child care: associations with infant-mother attachment, infant negative emotion, and cortisol elevations, Child Development May-Jun: 639-50. Research showing that in 15-month-olds separated from their mothers, cortisol levels rose over the first 60 minutes following the mothers’ departure, to levels that were 75-100% higher than at home. Watermura SE, Sebanc AM, Gunnar MR (2002) Rising cortisol at childcare: relations with nap, rest and temperament, Developmental Psychobiology Jan: 33-42. Research showing how infants separated from their parents and taken to a nursery had higher levels of cortisol and this increased as the day went on. Dettling AC, Gunnar MR, Donella B (1999) Cortisol levels of young children in full-day childcare centres: relations with age and temperament, Psychoneuroendocrinology Jun: 519-36. Research showing high cortisol levels in children in nurseries. Shyness in boys, and poor self-control and aggression in boys and girls, were associated with increases in cortisol in childcare. 29. Hertsgaard L, Gunnar M, Erikson MF, Nachmias M (1995) Adrenocortical responses to the strange situation in infants with disorganized / disorientated attachment relationships, Child Development 66: 1100-06. Gunnar MR (1989) Studies of the human infant’s adrenocortical response to potentially stressful events, New Directions for Child Development Fall: 3-18. Research showing that times of quiet and silence can be associated with larger elevations in cortisol than times of crying. 30. Belsky J (2001) Emanuel Miller lecture: Developmental risks (still) associated with early child care, Journal of Child Psychology and Psychiatry, and Allied Disciplines Oct: 845-59. Research showing that extensive non-maternal care is associated with elevated levels of aggression and noncompliance. Belsky J, Woodworth S, Crnic K (1996) Trouble in the second year: three questions about family interaction, Child Development Apr: 556-78. Research showing that children who have experienced 20 hours or more per week of non-maternal care in the first year of life were more likely to become troubled in their second year of life due to non-maternal care in the first year. 31. Gunnar MR, Larson MC, Hertsgaard L, Harris ML, Brodersen L (1992) The stressfulness of separation among nine-month-old infants: effects of social context variables and infant temperament, Child Development Apr: 290-303. Research showing that nine-month-old infants had a marked cortisol response to 30 minutes of separation when the substitute caregiver responded to infant distress but was did not interact when the babies were not showing distress. When she was warm and responsive throughout the entire separation period (even when the baby wasn’t crying), there was a significant reduction in cortisol activity and negative feeling. In fact, the infant’s cortisol levels were then just as low as when the infant was with the mother. Dettling AC, Parker SW, Lane S, Sebanc A, Gunner MR (2000) Quality of care and temperament determine changes in cortisol concentrations over the day for young children in childcare, Psychoneuroendocrinology Nov: 819-36. Research showing that in home-based childcare (e.g. nanny), when there was good attention and stimulation levels, the child did not suffer a rise in cortisol in the afternoons. 32. Harlow H F, Mears C (1979) Primate Perspectives, John Wiley, New York/London. Harlow C (1986) From learning to love, Praegar Publications, New York. 33. Ladd CO, Owens MJ, Nemeroff CB (1996) Persistent changes in corticotropin-releasing factor neuronal systems induced by maternal deprivation, Endocrinology Apr: 1212-18. Research showing that maternal deprivation can bring about long-term alterations to the hypothalamic-pituitary-adrenal (HPA) stress response system in the brain, which results in vulnerability to depression and other psychiatric disorders in later life. Sanchez MM, Ladd CO, Plotsky PM (2001) Early adverse experience as a developmental risk factor for later psychopathology: evidence from rodent and primate models, Development and Psychopathology Summer: 419-49. Research showing that maternal separation and loss in early life is associated with long-term alterations in emotional regulation capacities and changes in stress response and gene expression. This can lead to anxiety and depressive disorders. 34. Bowlby J (1973) Attachment and Loss: Volume 2 – Separation, Anxiety and Anger, Hogarth Press, London. Bowlby J (1979) The Making and Breaking of Affectional Bonds, Tavistock, London. Bowlby J (1988) A Secure Base: Clinical Applications of Attachment Theory, Routledge, London. CHAPTER THREE: SLEEP & BEDTIMES 1. Davis KF, Parker KP, Montgomery GL (2004) Sleep in infants and young children: part two – common sleep problems, Journal of Pediatric Health Care May-Jun;18(3):130-7. Research showing that about 25% of children younger than 5 years experience some type of sleep problem. Hiscock H, Jordan B (2004) Problem crying in infancy, The Medical Journal of Australia Nov 1;181(9):507-12. Up to 20% of parents report a problem with infant crying or irritability in the first 3 months of life. Crying usually peaks at 6 weeks and abates by 12-16 weeks. Lam P, Hiscock H, Wake M (2003) Outcomes of infant sleep problems: a longitudinal study of sleep, behavior, and maternal well-being, Pediatrics Mar;111(3):e203-07. Research demonstrating that persistence or recurrence of infant sleep problems in the preschool years is common and is associated with slightly higher child behavior problems and maternal depression scores. Despite this, families of children with sleep problems are functioning well. Armstrong KL, Quinn RA, Dadds MR (1994) The sleep patterns of normal children, The Medical Journal of Australia Aug 1;161(3):202-06. There is a wide range of normal childhood sleep behaviour. Circadian rhythm is not well established until four months of age. Frequent night-time wakening is common from four to 12 months. Night-time settling requires more parental input from 18 months. Parkinson D (1994) Overcoming sleep problems in babies and toddlers, Professional Care of Mother and Child Oct;4(7):215-17. In infants, sleep patterns are not as well developed as in adults. Infants spend a greater proportion of time in active sleep (REM sleep) than do adults. There is a wide range of normal sleeping behaviour in infancy, from almost continuous sleeping to less than nine hours out of 24. Anders TF, Eiben LA (1997) Pediatric sleep disorders: a review of the past 10 years, Journal of the American Academy of Child and Adolescent Psychiatry 36: 9-20. Research showing that 25-45% of healthy infants are said to suffer sleep disturbances or sleep problems. 2. Frost J (2005) Supernanny, Hodder & Stoughton, London. Byron T, Baveystock S (2003) Little Angels, BBC Worldwide Learning, London. 3. Harrison Y (2004) The relationship between daytime exposure to light and night-time sleep in 6-12 week old infants, Journal of Sleep Research Dec;13(4):345-52. Researchers at Liverpool John Moores University found babies who slept well were exposed to twice as much light between 12pm and 4pm as poor sleepers. “One possible explanation for the link between light exposure and sleep is that higher light levels encourage the early development of the biological clock which regulates a number of bodily functions, including the secretion of melatonin.” BBC news, Monday 22 November 2004. 4. McKenna JJ, Thomas EB, Anders TF, Sadeh A, Schechtman VL, Glotzbach SF (1993) Infant-parent co-sleeping in an evolutionary perspective: implications for understanding infant sleep development and the sudden infant death syndrome, Sleep Apr;16(3):263-82. Research demonstrating that a co-sleeping environment may foster the development of optimal sleep patterning in infants and confer other benefits. Field T (1994) The effects of mother’s physical and emotional unavailability on emotion regulation, Monographs of the Society for Research in Child Development 59;(2-3):208-27. Research demonstrating that physical and emotional unavailability from the mother (as in maternal depression) caused problems with cortisol levels, sleep, eating, toileting, and the immune system. The unavailability meant that the child was deprived of a regulator of stimulation (the mother), so did not develop an organized physiological rhythm. Richard C, Mosko S, McKenna J, Drummond S (1996) Sleeping position, orientation, and proximity in bed sharing infants and mothers, Sleep Nov;19(9):685-90. Research demonstrating that bed-sharing mothers and infants spent most of the night turned towards each other. This orientation and proximity should facilitate sensory exchanges between mother and infant, influencing the infant’s sleep physiology. McKenna JJ, Mosko SS, (1994) Sleep and arousal, synchrony and independence, among mothers and infants sleeping apart and together (same bed): an experiment in evolutionary medicine, Acta Paediatrica Supplementum Jun;397:94-102. Co-sleeping provides a sensorily rich environment, which is associated with enhanced infant arousal and overlap in infant and maternal arousal. 5. McKenna JJ (1986) An anthropological perspective on the sudden infant death syndrome (SIDS): the role of parental breathing cues and speech breathing adaptations, Medical Anthropology 10: 9-53. Bergman N (2005) More than a cuddle: skin-to-skin contact is key, The Practising Midwife Oct;8(9):44. Bergman N (1999) Charge for the future of KC: a public health imperative, Kangaroo.javeriana.edu.co/abstract42.htm Cacioppo JT, Hawkley LC, Crawford LE, Ernst JM, Burleson MH, Kowalewski RB, Malarkey WB, Van Cauter E, Berntson GG (2002) Loneliness and health: potential mechanisms, Psychosomatic Medicine May-June;64(3):407-17. Research showing that when adults and children feel lonely they have poorer sleep, higher heart rate, and increases in blood pressure. Cardiovascular activation and sleep dysfunction are pre-disease mechanisms. Richard CA, Mosko SS (1997) Infant arousals during mother-infant bed sharing: implications for infant sleep and sudden infant death syndrome research, Pediatrics Nov;100(5):841-49. Heart-rate variability was higher during solitary sleeping than during bed-sharing. McKenna JJ, Mosko S, Dungy C, McAninch J (1990) Sleep and arousal patterns of co-sleeping human mother/infant pairs: a preliminary physiological study with implications for the study of sudden infant death syndrome (SIDS), American Journal of Physical Anthropology Nov;83(3):331-47. Research showing that co-sleeping mothers and infants exhibit synchronous arousals, which, because of the suspected relationship between arousal and breathing stability in infants, have important implications for how we study environmental factors possibly related to some forms of the sudden infant death syndrome (SIDS). McKenna J, Mosko S, Richard C, Drummond S, Hunt L, Cetel MB, Arpaia J (1994) Experimental studies of infant-parent co-sleeping: mutual physiological and behavioral influences and their relevance to SIDS (sudden infant death syndrome), Early Human Development Sep 15;38(3):187-201. Research demonstrating that in co-sleeping maternal sensory exchanges are likely, involving heat, sound, gas, smells, movement, and touch, inducing physiological regulation of arousal, body temperature, and sleep patterns. Co-sleeping leads to increased breast-feeding. 6. Bergman N (2005) More than a cuddle: skin-to-skin contact is key, The Practising Midwife Oct;8(9):44. See also Jackson D (1999) Three in a bed: The benefits of sleeping with your baby, Bloomsbury, London. 7. Kramer KM, Cushing BS, Carter CS (2003) Developmental effects of oxytocin on stress response: single versus repeated exposure, Physiology and Behaviour Sept;79(4-5):775-82. Research demonstrating that oxytocin reduces the stress response. Oxytocin in early post-natal period affected physiology and behaviour, producing effects that lasted into adulthood. Hofer MA (1996) On the nature and consequences of early loss, Psychosomatic Medicine Nov- Dec;58(6):570-81. Research demonstrating how, in early infancy, the emotionally responsive mother will regulate the child’s physiology, e.g. digestion and temperature control, developing his or her bodily arousal system, so mother-child interactions play a vital role in regulating the child’s physiological systems as well as regulating neurochemical systems in the developing brain. Buckley P, Rigda RS, Mundy L, McMillen IC (2002) Interaction between bed sharing and other sleep environments during the first six months of life, Early Human Development Feb;66(2):123-32. Bed-sharing means increased parental proximity during the first six months of life. Uvnas-Moberg K, Petersson M (2005) Oxytocin, a mediator of anti-stress, well-being, social interaction, growth and healing, Zeitschrift fur Psychosomatische Medizin und Psychotherapie 51(1):57-80. Repeated exposure to oxytocin causes long-lasting effects by influencing the activity of other transmitter systems, a pattern that makes oxytocin potentially clinically relevant. Oxytocin can be released by touch. This means that positive interaction involving touch and psychological support may be health-promoting. “Both exogenous and endogenous oxytocin (OT) are associated with an attenuated stress response. Increased levels of OT in the early postnatal period have been shown to affect behavior and physiology … and these effects last into adulthood, suggesting an organizational role for OT during development.” Kramer KM, Cushing BS, Carter CS (2003) Developmental effects of oxytocin on stress response: single versus repeated exposure, Physiology & Behavior Sept;79(4-5):775-82. Mayer EA, Naliboff BD, Chang L, Coutinho SV (2001) Stress and the gastrointestinal tract V: stress and irritable bowel syndrome, American Journal of Physiology. Gastrointestinal Liver Physiology 280: G519-G524. Research demonstrating that moderate periods of maternal separation in newborns produce permanent alterations in the infants’ stress responsiveness. This can also lead to colonic motor dysfunction in response to stress, thereby mimicking all the main features of IBS (irritable bowel syndrome). Alfven G (2004) Plasma oxytocin in children with recurrent abdominal pain, Journal of Pediatric Gastroenterology and Nutrition May;38(5):513-17. Research demonstrating that oxytocin levels are lower in children with recurrent abdominal pain of psychosomatic origin and children with irritable bowel syndrome. 8. Keller M, Goldberg W (2000) “Co-sleeping and children independence: challenging the myths”; in McKenna J (Ed) Safe Sleeping with Baby: Evolutionary, Developmental and Clinical Perspectives, University of California Press, California. Also McKenna J (2000) “Cultural influences on infant and childhood sleep biology and the science that studies it: toward a more inclusive paradigm”; in Loughlin J, Carroll J, Marcus C (Eds) Sleep in Development and Pediatrics, Marcel Dekker, New York: 99-230. Research showing that children who have never slept in their parents’ bed were harder to control; less happy; less able to be alone; more fearful; and had a greater number of tantrums. McKenna J, McDade T (2005) Why babies should never sleep alone: a review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding, Paediatric Respiratory Reviews 6(2):134-152. Children who slept with parents between birth and five years of age had higher self-esteem in adulthood and lower anxiety levels. Also, boys who co-slept between 6 and 11 had higher self-esteem. Okami P, Weisner T, Olmstead R (2002) Outcome correlates of parent-child bedsharing; an eighteen-year longitudinal study, Journal of Developmental and Behavioural Pediatrics 23: 244- 254. Studies linking co-sleeping in childhood (even in one case up to the age of 11) with higher self-esteem and less anxiety in adulthood. Kalin NH, Shelton SE, Barksdale CM (1988) Opiate modulation of separation-induced distress in non-human primates, Brain Research Feb 9;440(2):285-92. Research showing that separation activated the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) system, but that opioids soothed the distress. Caldji C, Tannenbaum B, Sharma S, Francis D, Plotsky PM, Meaney MJ (1998) Maternal care during infancy regulates the development of neural systems mediating the expression of fearfulness in the rat, Proceedings of the National Academy of Sciences of the United States of America 95: 5335-40. Research showing that the animals who received the most physical contact in infancy exhibited the least fear in adulthood. 9. Horne J (1985), New Scientist Dec; cited in Jackson D (1999) Three in a bed: The benefits of sleeping with your baby, Bloomsbury, London. 10. Eight hundred hours of video material of mothers and babies, compiled by researchers in Bristol. “Even when asleep, mothers appeared to be aware or sense the presence of their baby in bed with them and at no time was a mother ever observed to roll on her infant, even when sleeping very close together.” Young J, “Bedsharing with Babies; The Facts” (1998); in Jackson D (1999) Three in a bed: The benefits of sleeping with your baby, Bloomsbury, London. 11. Gaultier C (1995) Cardiorespiratory adaptation during sleep in infants and children, Pediatric Pulmonology Feb;19(2):105-17. Research showing that the cardiorespiratory control system undergoes functional maturation after birth. Until this process is completed, the system is unstable, placing infants at risk for cardiorespiratory disturbances, especially during sleep. 12. Kibel MA, Davies MF (2000) “Should the infant sleep in mother’s bed?” In Sixth SIDS International Meeting, Auckland, New Zealand, Feb 8-11. One study showed only 4% of Asian babies sleep alone. Studies show low incidence of SIDS in Asian populations. In China, Vietnam, Cambodia and Thailand SIDS is virtually unheard of; a baby sleeping alone is very rare. Farooqi S (1994) Ethnic differences in infant care practices and in the incidence of sudden infant death syndrome in Birmingham, Early Human Development Sep 15;38(3):209-13. Research demonstrating that the incidence of SIDS in the UK amongst Asians was less than half that in whites. The majority of Asian infants slept in the parental bedroom at night; only 4% of Asian babies slept alone. 13. Michael Odent, French birth pioneer, visited China and found that, when asking about cot death, medical professionals didn’t know what he was talking about. “Nobody understood my questions; the concept of sudden infant death or cot death was apparently unknown among professionals and lay people in such different places as Peking, Hsian, Loyang, Nanking, Shanghai, and Canton. Furthermore I learned that Chinese babies sleep with their mothers … Ever since then I have held the view that even if it happens during the day, cot death is a disease of babies who spend their nights in an atmosphere of loneliness and that cot death is a disease of societies where the nuclear family has taken over.” The Lancet (1986) 25 Jan; cited in Jackson D (1999) Three in a bed: The benefits of sleeping with your baby, Bloomsbury, London. 14. Davies DP (1985) Cot death in Hong Kong: a rare problem? Lancet 2: 1346-48. Research showing that in Hong Kong, where co-sleeping is the norm due in part to living conditions, the rates of SIDS are one of the lowest in the world. In Hong Kong, over a five-year period, there were only 15 cases of cot death. In western countries 800-1200 cot deaths might have been expected over this same period. 15 and 16. Studies cited in Jackson (1999) Three in a bed: The benefits of sleeping with your baby, Bloomsbury, London: 106-30. 17. Bergman N ( 2005) More than a cuddle: skin-to-skin contact is key, The Practising Midwife Oct;8(9):44. “Bergman’s extensive research shows that when the baby is separated from its mother, there can be a ten fold increase in stress hormones. Such levels are neurotoxic. (Modi and Glover 1998) Removed from their correct habitat (the mother’s body) all infant mammals exhibit an identical pre-programmed response referred to as the “protest-despair” response. (Alberts 1994) The protest response is one of intense activity seeking reuniting with the mother, the despair response is a withdrawal and survival response mediated by a massive rise in stress hormones. Separation stress also has powerful inhibitory effects on all gastrointestinal functions. Somatostatin is released depressing all beneficial hormones in the baby’s gut as well as growth hormone (Uvnas-Moberg 1989) There are also major fluctuations in breathing, temperature and heart rate. Bergman N (1999) Charge for the future of KC: a public health imperative, Kangaroo.javeriana.edu.co/abstract42.htm 18. Latz S, Wolf AW, Lozoff B (1999) Co-sleeping in context: sleep practices and problems in young children in Japan and the United States, Archives of Pediatrics & Adolescent Medicine Apr;153(4):339-46. Research demonstrating that cultural differences influence sleep problems. Most Japanese children have adult company and body contact as they fall asleep. The experience of the Japanese families indicates that co-sleeping per se is not associated with increased sleep problems in early childhood. American children have regular bedtime struggles and waking and sleep problems. Lozoff B, Askew GL, Wolf AW (1996) Co-sleeping and early childhood sleep problems: effects of ethnicity and socioeconomic status, Journal of Developmental and Behavioral Pediatrics Feb;17(1):9-15. Research demonstrating that child-rearing attitudes and expectations influenced how parents interpreted their children’s sleep behaviour. In some social groups, co-sleeping was associated with increased night waking and bedtime protests; in others, this was not people’s experience of co-sleeping. 19. “Studies show that a lot of parents in the UK sleep with their children. One study at The Institute for Child Health, London, found that 70 percent of 4-16 year olds came to their parents’ beds regularly at least once a week. Up to 47 percent of toddlers and 36 percent of preschoolers wake up at least once a night and need an adult to help them to fall back to sleep Almost half of all toddlers and preschoolers require a parent to stay in their room until they fall asleep.” Pantley E (2005) The No-Cry Sleep Solution, McGraw-Hill, New York: 327. 20. Pantley E (2005) The No-Cry Sleep Solution, McGraw-Hill, New York: 9. Zhong X, Hilton HJ, Gates GJ, Jelic S, Stern Y, Bartels MN, Demeersman RE, Basner RC (2005) Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation, Journal of Applied Physiology Jun;98(6):2024-32. Research showing that sleep deprivation is associated with increased sympathetic and decreased parasympathetic cardiovascular modulation. 21. “Infants are observed to be ‘staring into space with a glazed look.’ The fear or terror involves numbing, avoidance, compliance, mediated by high levels of behaviour-inhibiting cortisol, pain-numbing endogenous opioids, … dissociation is ‘the escape where there is no escape’ (Putnam 1997), ‘a last resort defensive strategy’ (Dixon 1998)”. Schore A (2003) Affect Regulation and the Repair of the Self, W.W. Norton & Company, New York: 66-67. Hertsgaard L, Gunnar M, Erikson MF, Nachmias M (1995) Adrenocortical responses to the strange situation in infants with disorganized / disorientated attachment relationships, Child Development 66, 1100-06. Research demonstrating that some children clearly bottle up feelings from the age of one year. Perry BD, Pollard RA, Blakely TL, Baker WL, Vigilante D (1995) Childhood trauma, the neurobiology of adaptation, and ‘use dependent’ development of the brain. How ‘states’ become ‘traits’, Infant Mental Health Journal 16: 271-91. Research showing that babies and children left in states of chronic distress (e.g. those who are not comforted in high levels of stress) move from states of hyperarousal to an emotional cutting off (dissociation). The more a child is in a state of hyperarousal or dissociation, the more likely they are to have neuropsychiatric symptoms following trauma. So these adaptive mechanisms to deal with intense emotional pain by numbing can actually become maladaptive personality traits. Perry calls the infant’s frantic distress (Schore 2003) fear – terror, which activates high levels of stress hormones and increased blood pressure, heart rate, and respiration. 22. Post RM, Weiss SRB, Leverich GS (1994) Recurrent affective disorder: roots in developmental neurobiology and illness progression based on changes in gene expression, Development and Psychopathology 6: 781-813. Research demonstrating that stress in early childhood may leave behind a permanent physiological hyper-reactivity. Levine S, Wiener SG, Coe CL (1993) Temporal and social factors influencing behavioral and hormonal responses to separation in mother and infant squirrel monkeys, Psychoneuroendocrinology 18(4):297-306. Research showing the effects of 1-, 3-, 6-, and 24-hr separations. It was found that signs of infant behavioral agitation decreased over time, whereas adrenocortical activation persisted or even increased. Separated infants vocalized significantly more when their mothers were proximal than when isolated. These data indicate that the intensity of the infant’s calling response cannot be used to predict internal state (as reflected by cortisol levels). Silove D, Manicavasagar V, Curti J, Blaszczynski A (1996) Is early separation anxiety a risk factor for adult panic disorder? A critical view, Comprehensive Psychiatry May-June;37(3):167-79. Research showing that separation anxiety in early life is a risk factor for adult panic disorder. Thayer JF, Lane RD (2000) A model of neurovisceral integration in emotion regulation and dysregulation, Journal of Affective Disorders Dec;61(3):201-16. Research demonstrating that the sympathetic activation in anxiety disorders may be due to faulty inhibitory mechanisms. 23. Bremner JD, Innis RB, Southwick SM, Staib L, Zoghbi S, Charney DS (2000) Decreased benzodiazepine receptor binding in prefrontal cortex in combat-related posttraumatic stress disorder, The American Journal of Psychiatry Jul;157(7):1120-26. Animals exposed to stress exhibit a decrease in benzodiazepine receptor binding in the frontal cortex. These findings of lower values for the benzodiazepine receptor binding measure of distribution volume are consistent with fewer benzodiazepine receptors and/or reduced affinity of receptor binding in the medial prefrontal cortex in patients with PTSD. Alterations in benzodiazepine receptor function in the area may underlie many of the symptoms of PTSD. Adamec RE, Shallow T, Budgell J (1997) Blockade of CCK (B) but not CCK (A) receptors before and after the stress of predator exposure prevents lasting increases in anxiety-like behavior: implications for anxiety associated with posttraumatic stress disorder, Behavioral Neuroscience Apr; 111(2):435-49. Adamec R (1994) Modelling anxiety disorders following chemical exposures, Toxicology and Industrial Health Jul-Oct;10(4-5):391-420. Research showing that by kindling a fear system in the brain of an animal over a relatively short period of time, the animal could develop a fearful personality. The equivalent is a child who has had repeated activation of the FEAR system in the brain in childhood, making him vulnerable to developing PTSD as a result of experiencing an acute stressor in later life. Caldji C, Diorio J, Meaney MJ (2003) Variations in maternal care alter GABAA receptor subunit expression in brain regions associated with fear, Neuropsychopharmacology 28: 1950-59. Research demonstrating how maternal care can adversely or positively affect gene expression of GABAA receptors in the brain, hence underlining the well-established relationship between early life events and vulnerability for anxiety disorders in later life. 24. Ziabreva I, Schnabel R, Poeggel G, Braun K (2003) Mother’s voice “buffers” separation-induced receptor changes in the prefrontal cortex of Octodon degus, Neuroscience 119(2):433-41. Research with other mammals showing that the acoustic presence of the mother during parental separation suppressed some of the adverse changes in brain chemistry; thus the mother’s voice can protect the higher brain from some of the long-term adverse chemical changes. Ziabreva I, Poeggel G, Schnabel R, Braun K (2003) Separation-induced receptor changes in the hippocampus and amygdala of Octodon degus: influence of maternal vocalizations, Journal of Neuroscience Jun 15;23(12):5329-36. Research with other mammals showing that early adverse emotional experience can alter the function of certain brain chemicals within the hippocampus and amygdala and that the mother’s voice, a powerful emotional signal, can modulate these effects in the developing emotional brain. 25. The story on the tape idea is in Pantley E (2005) The no-cry sleep solution, McGraw-Hill, New York: 327. 26. Field T, Kilmer T, Hernandez-Reif M, Burman I (1996) Preschool children’s sleep and wake behavior: effects of massage therapy, Early Child Development and Care 120: 39-44. Research demonstrating that preschool children who received massage fell asleep sooner, slept longer during naptime, and had better behavior ratings. Field T, Hernandez-Reif M (2001) Sleep problems in infants decrease following massage therapy, Early Child Development and Care 168: 95-104. Research demonstrating that infants who received massage therapy before bedtime by a parent experienced less difficulty falling asleep and better sleep patterns. CHAPTER FOUR: THE CHEMISTRY FOR LIVING LIFE WELL 1. “Each of us has his or her own … finest drugstore available at the cheapest cost – to produce all the drugs we ever need to run our body–mind.” Pert CB (1997) Molecules of Emotion, Simon & Schuster UK, London: 271. “Hormones can be enormously powerful in the influencing of feelings, perception and behaviour. … [It is hormones] that allow caterpillars to become butterflies and human children to become adults” Panksepp J (1998) Affective Neuroscience, Oxford University Press, New York: 25. 2. Mahler M (1968) On Human Symbiosis and the Vicissitudes of Individuation, International Universities Press, New York. Emotional refueling is a concept coined by Margaret Mahler. 3. McCarthy MM, Altemus M (1997) Central nervous system actions of oxytocin and modulation of behavior in humans, Molecular Medicine Today 3(6):269-75. Research showing that the pituitary hormone oxytocin has modulatory effects on neural functioning that are significant for the regulation of behavior. Oxytocin is key to calming parenting behaviours and effective responses to stress. Uvnas-Moberg K (1997) Physiological and endocrine effects of social contact, Annals of the New York Academy of Sciences 15;807:146-63. Research showing that friendly social interaction activates oxytocin, which induces relaxation, decreased sympathoadrenal activity, and increased vagal nerve tone, an antithesis to the fight – flight response. The health-promoting aspect of friendly and supportive relationships might be a consequence of repeated exposure to these physiological and endocrine changes. Zubieta JK, Ketter TA, Bueller JA, Xu Y, Kilbourn MR, Young EA, Koeppe RA (2003) Regulation of human affective responses by anterior cingulate and limbic and m-opioid neurotransmission, General Psychiatry Nov;60(11):1037-1172. Research showing that opioid activation in the brain has been shown to reduce noradrenaline release. Panksepp J (2004) Affective consciousness and the origins of human mind: a critical role of brain research on animal emotions, Impuls 57, 47-60. Article commenting on how sadness decreases natural opioid activity in the brain – so it is no coincidence that lonely young people are becoming addicted to opiates (e.g. heroin), in order to seek out those warm feelings pharmacologically, rather than through positive human relationships. “Brain oxytocin, opioids and prolactin systems appear to be the key participants in these subtle feelings that we humans calls acceptance, nurturance and love – the feelings of social solidarity and warmth. Although many human interactions and cognitive experiences also contribute to maternal states, without the underlying mood- and behaviour- altering neuropeptides, those experiences would probably remain shallow and without emotional intensity.” Panksepp J (1998) Affective Neuroscience, Oxford University Press, New York: 249. “In young animals some of the most beneficial changes may result simply from loving touch, some of which may emerge from oxytocin and upload release, which are known to solidify infant – mother bonds” Nelson and Panksepp (1996), Panksepp (2001) The long-term psychobiological consequences of infant emotions – prescriptions for the twenty-first century, Infant Mental Health Journal Jan-Apr;22(1-2):151. 4. Heim C, Nemeroff CB (2001) The role of childhood trauma in the neurobiology of mood and anxiety disorders: preclinical and clinical studies, Biological Psychiatry 15;49(12):1023-39. Research showing that early life stress induces long-lived hyperactivity of corticotropin-releasing factor (CRF) systems as well as alterations in other neurotransmitter systems, resulting in increased stress responsiveness. Studies suggest that exposure to early life stress is associated with neurobiological changes in children and adults, which may underlie the increased risk of psychopathology. 5. Uvnas-Moberg K, Petersson M (2005) Oxytocin, a mediator of anti-stress, well being, social interaction, growth and healing, Zeitschrift fur Psychosomatische Medizin und Psychotherapie 51(1):57-80. Research showing that oxytocin is a mediator of stress relief and well being. It can reduce blood pressure and cortisol levels. Oxytocin can be released by various types of non-noxious sensory stimulation; for example, by touch and warmth, sound and light. In addition, purely psychological mechanisms may trigger the release of oxytocin. This means that positive interaction involving touch and psychological support may be health-promoting. Kramer KM, Cushing BS, Carter CS (2003) Developmental effects of oxytocin on stress response: single versus repeated exposure, Physiology & Behavior 79(4-5):775-82. Research showing how early parent-infant interactions that activate oxytocin (e.g. touch, soothing tone) have a long-term positive influence on the brain’s stress response. Carter CS (2003) Developmental consequences of oxytocin, Physiology & Behavior 79(3):383-97. Research showing how oxytocin is capable of moderating reactivity in a key stress response system in the brain: the hypothalamic-pituitary-adrenal (HPA) axis. Uvnas-Moberg K (1997) Oxytocin linked anti-stress effects – the relaxation and growth response, Acta Physiologica Scandinavica. Supplementum 640:38-42. Research showing how repeated activation of oxytocin is linked to the long-term effects of lowering blood pressure and decreasing corticosterone levels, with a resulting improved capacity to manage stress. Positive social contact that activates oxytocin may have health-promoting effects by preventing cardiovascular disease. Francis DD, Diorio J, Plotsky PM, Meaney MJ (2002) Environmental enrichment reverses the effects of maternal separation on stress reactivity, Journal of Neuroscience 22(18):7480-83. Research showing that the activation of oxytocin from social interaction can have a potent anti-stress effect. If regularly activated, it can decrease blood pressure and cortisol levels and boost immune response. 6. Plotsky PM, Thrivikraman KV, Meaney MJ (1993) Central and feedback regulation of hypothalamic corticotrophin-releasing factor secretion, Ciba Foundation Symposium 172: 59-75. Research showing how early childhood experience has a lasting influence on the hypothalamic-pituitary-adrenal (HPA) axis, a key stress-regulating system in the brain. 7. Insecure attachment definition first formulated by John Bowlby (1979) The Making and Breaking of Affectional Bonds, Tavistock, London. 8. Liu D, Diorio J, Tannenbaum B, Caldji C, Francis D, Freedman A, Sharma S, Pearson D, Plotsky PM, Meaney MJ (1997) Maternal care, hippocampal glucocorticoid receptors, and hypothalamic-pituitary-adrenal responses to stress, Science 277(5332):1659-62. Research showing that high levels of touch in childhood resulted in improved responses to acute stress and lower levels of stress chemicals in later life. Caldji C, Diorio J, Meaney M (2003) Variations in maternal care alter GABAA receptor subunit expression in brain regions associated with fear, Neuropsychopharmacology 28: 1950-59. Research showing that children who had high levels of touch in childhood had a far less fearful response in later life. They also aged better and became confident mothers with calmer infants. In contrast, low levels of touch in childhood resulted in increased fearfulness in later life and increased stress reactivity. Research also showed that comforting maternal behaviour has a profound influence on GABA gene expression in the infant’s brain, thus enabling infants to be less vulnerable to developing anxiety disorders in later life. Maternal care can adversely or positively effect gene expression of GABAA receptors in the brain, hence underlining the well-established relationship between early life events and vulnerability for anxiety disorders in later life. Scantamburlo G, Ansseau M, Legros, JJ (2001) Role of the neurohypophysis in psychological stress, Encephale May-Jun;27(3):245-59. Research showing that oxytocin (e.g as activated by soothing physical contact) moderates the effect of stress chemicals. People with anorexia nervosa have reduced oxytocin levels, which may exacerbate the maintaining of their cognitive distortions. 9. Francis DD, Young LJ, Meaney MJ, Insel TR (2002) Naturally occurring differences in maternal care are associated with the expression of oxytocin and vasopressin receptors, Journal of Neuroendocrinology 14: 349-53. Research showing that touch in early childhood resulted in less fear and better mothering capacities in adulthood. Flemming AS, O’Day DH, Kraemer GW (1999) Neurobiology of mother–infant interactions; experience and central nervous system plasticity across development and generations, Neuroscience and Biobehavioral Reviews May: 673-85. Research with other mammals showing that high levels of touch in infancy positively affect the infant’s capacity to handle stress well in adulthood. This is due to long-term changes in brain mechanisms that modulate stress reactivity. 10. Panksepp J (2004), personal communication. 11. Depue RA, Luciana M, Arbisi P, Collins P, Leon A (1994) Dopamine and the structure of personality: relation of agonist-induced dopamine activity to positive emotionality, Journal of Personality and Social Psychology 66(4):762-75. Research showing that dopamine is a key chemical in positive emotionality. Personality traits in terms of degree of positivity may be related to individual differences in brain dopamine functioning. “When lots of dopamine synapses are firing, a person feels as if he or she can do anything.” Panksepp J (1998) Affective Neuroscience, Oxford University Press, New York: 144. “There are biological mechanisms behind the most sublime human behaviour.” Damasio A (1996), Descartes’ Error, Papermac, London: 183. 12. Aitken KJ, Trevarthen C (1997) Self/other organisation in human psychological development, Development and Psychopathology 9: 653-77. Research showing that babies are genetically programmed to be able to enter into dialogue with face, voice, gesture and body movements. Trevarthen C (1993) “The Self born in intersubjectivity: the psychology of an infant communicating”, cited in Neisser U (Ed) (1995) The Perceived Self: ecological and interpersonal sources of self knowledge, Press Syndicate of the University of Cambridge, Cambridge: 123. 13. “The unconditionally rewarding and exciting properties of the mother’s gaze in these imprinting [on the brain] experiences … activate … dopaminergic elation (Kelley and Stinus 1984) and dopaminergic arousal in the infant.” Schore A (1994) Affect Regulation and the Origins of the Self - The Neurobiology of Emotional Development, Lawrence Erlbaum Associates, New Jersey. 14. “… the regulatory transactions embedded in the emotional relationship are occurring at a time when the infant’s circuitry of the biological hardware of arousal is expanding. In fact, there are specific postnatal critical periods and development sequences for the appearance of … dopamine and noradrenaline. Central catecholaminergic neurons undergo an accelerated development in mammalian infancy, and their proliferating axonal terminals hyperinnervate distant corticol territories. These events are experience-dependent, and they account for the evolution of an increasing tolerance for higher levels of arousal over the course of the 1st year.” Schore A (1997) Early organization of the nonlinear right brain and development of a predisposition to psychiatric disorders, Development and Psychopathology 9, 595-631: 603. “An essential function of the mother is to permit the child to bear increasingly intense affective tension, but then to step in and comfort the child before his emotions overwhelm him … a major task of the first year is the evolution of affective tolerance for increasingly higher levels of arousal, and that this task is facilitated by the mother’s modulation of the infant’s highly stimulated states.” Schore A (1996) The experience-dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of development psychopathology, Development and Psychopathology 8: 59-87. 15. Beebe B, Lachmann F (1988) The contribution of mother-infant mutual influence to the origins of self- and object representations, Psychoanalytic Psychology 5(4): 305-37. 16. “Everyone looks for that sparkle in friends and lovers to ‘make things happen’. Most of all everybody is looking for energy within themselves: the motivation and drive to get up and do something, the endurance, stamina and resolve to carry through ...” Brown, B (1999), Soul Without Shame: A Guide to Liberating Yourself from the Judge Within, Shambhala Publications Inc, USA: 157. 17. Panksepp J (1998) Affective Neuroscience, Oxford University Press, New York. See Part 11 Chapter 8, SEEKING systems and Anticipatory States of the Nervous System: 144. And when the brain’s seeking system is highly activated it “helps...[people] to move their bodies effortlessly in search of the things they need, crave and desire.” Panksepp J (1998) Affective Neuroscience, Oxford University Press, New York: 53. 18. Depue RA, Collins PF (1999) Neurobiology of the structure of personality: dopamine, facilitation of incentive motivation, and extraversion, The Behavioral and Brain Sciences 22(3): 491-517. Research showing that there are differences in dopamine projections in the brain, which then affect motivation. Some of these differences are genetic, while some are experience-dependent. “When dopamine synapses are active in abundance, a person feels as if he or she can do anything. Is it any wonder that humans and animals eagerly work to artificially activate this system whether via electrical or chemical means.” Panksepp J (1998) Affective Neuroscience, Oxford University Press, New York: 144. 19. Belz EE, Kennell JS, Czambel RK, Rubin RT, Rhodes ME (2003) Environmental enrichment lowers stress-responsive hormones in singly housed male and female rats, Pharmacology, Biochemistry, and Behavior: 481-86. Research showing that an enriched environment (stimulating toys!) lowers stress chemicals and enables mammals to deal better with stressful situations. The article also makes the point that boredom and low stimulation is stressful. Green TA, Cain ME, Thompson M, Bardo MT (2003) Environmental enrichment decreases nicotine-induced hyperactivity in rats, Psychopharmacology: 235-41. Research showing that mammals living in an enriched environment, when given nicotine, found it far less stimulating than animals who had not known an enriched environment. 20. In an experiment with rats, some of the rats were given an enriched environment with “climbing tubes and running wheels, novel food and lots of social interaction. Two months later the rats in the enriched environment had an extra 50,000 brain cells in each side of the hippocampus [one of the memory and learning centres in the brain].” Fred Gage Salk, Institute for Biological Studies, La Jolla, California; cited in Carper J (2000) Your Miracle Brain, Harper Collins, New York: 31-32. 21. Raine A, Mellinger K, Liu J, Venables P, Mednick SA (2003) Effects of environmental enrichment at ages 3-5 years on schizotypal personality and antisocial behaviour at ages 17 and 23 years, The American Journal of Psychiatry: 1627-35. Research showing that if children were given a nutritional, educational and physical exercise-enriched programme between 3 and 5 years of age, they were far less likely to develop criminal or anti-social behaviour in early adulthood, and far less likely to suffer from schizophenia. 22. Morley-Fletcher S, Rea M, Maccari S, Laviola G (2003) Environmental enrichment during adolescence reverses the effects of prenatal stress on play behaviour and HPA axis reactivity in rats, European Journal of Neuroscience 18(12): 3367-74. Research showing that mammals which are prenatally exposed to stress (and showing impaired social play behaviour, anxiety, and increased stress responsiveness) can benefit during adolescence from the modulatory effects of an enriched environment. This can also compensate for (although not reverse) the effects of prenatal stress and the stress of postnatal maternal separation on hardwired over-reactive stress response systems in the brain. 23. Murray J ( 2001) TV violence and brainmapping in children, Psychiatric Times XV111 (10). Research showing that when children watch violence on TV, or in computer games, it can increase aggressive behaviour. This is partly due to the fact that the part of the brain to do with the motor rehearsal of aggressive movement lights up. Also, new memories are encoded, which are similar to those encoded after traumatic events in post-traumatic stress disorder. Watching violent films activated the amygdala (brain area to do with the detection of threat). 24. Seib HM, Vodanovich SJ (1998) Cognitive correlates of boredom proneness: the role of private self-consciousness and absorption, The Journal of Psychology 132(6): 642-52. Proneness to boredom is far lower for people who have a better capacity for absorption and better levels of awareness of internal states. 25. Barbalet JM (1999) Boredom and social meaning, The British Journal of Sociology 50(4): 631-46. Research showing that people feel boredom when they find no meaning or appeal in their current situation or activity; therefore, boredom prompts them to search for meaning. 26. Bar-Onf ME (1999) Turning off the television, British Medical Journal April 24. Research showing that an average child in the UK watches 21 hours of TV a week, not including time spent watching videos. Over 4,000 studies on effects of TV on children show higher rates of aggressive behaviour and lower academic performance. 27. “People take psychostimulants to give them the very sense of vigorously pursuing courses of action that they would get from a healthy SEEKING circuit. Cocaine produces a highly energised state of psychic power and engagement with the world.” Panksepp J (1998) Affective Neuroscience, Oxford University Press, New York: 118. 28. Gordon N, Burke S, Akil H, Watson S, Panksepp J (2003) Socially-induced brain “fertilization”: play promotes brain derived neurotrophic factor transcription in the amygdala and dorsolateral frontal cortex in juvenile rats, Neuroscience Letters 341(1-24): 17-20. Research showing that social play increases the activation of a vital brain fertilizer called brain derived neurotrophic factor (BDNF), which helps to programme the higher brain regions involved in regulating emotional behaviours (e.g. helps a child to manage her feelings better). There was higher gene expression in the frontal lobe after play: “The dorsolateral frontal cortex [area of the brain to do with planning] had significantly elevated BDNF expression as a result of play”. 29. Panksepp J, Burgdorf J, Turner C, Gordon N (2003) Modeling ADHD-type arousal with unilateral frontal cortex damage in rats and beneficial effects of play therapy, Brain and Cognition. Research showing that social play can decrease impulsivity and overactivity (ADHD behaviour) and increase the capacity for focused attention, suggesting that play may produce a brain state compared to that induced by low doses of Ritalin. Hyperactive rats were given extra social play, and this reduced impulsive symptoms. Research also suggested that one of the long-term functions of social play is to promote maturation of the frontal lobe. 30. Panksepp J (1993) “Rough and tumble play: a fundamental brain process”. Cited in MacDonald KB (Ed) Parents and Children Playing, SUNY Press, Albany, NY: 147-184. Research showing that if mammalian infants are deprived of social play, they will make up for lost time and play all the harder when given the chance. Ikemoto S, Panksepp J (1992) The effects of early social isolation on the motivation for social play in juvenile rats, Developmental Psychobiology May;25(4):261-74. Research suggesting that prolonged isolation increases the need for social play. 31. Pellegrini A, Davis Huberty P, Jones I (1996) The effects of recess timing on children’s playground and classroom behaviours, American Educational Research Journal 32(4): 845-64. See also Pellegrini A, Horvat M (1995) A developmental contextualist critique of attention deficit/hyperactivity disorder, Educational Researcher 24(1): 13-20. 32. Panksepp J, Burgdorf J, Turner C, Gordon N (2003) Modeling ADHD-type arousal with unilateral frontal cortex damage in rats and beneficial effects of play therapy, Brain and Cognition. 33. Beatty WW, Dodge AM, Dodge LJ, White K, Panksepp J (1982) Psychomotor stimulants, social deprivation and play in juvenile rats, Pharmacology, Biochemistry, and Behavior Mar;16(3):417-22. Research showing that Ritalin decreases play behaviour. Stimulation of catecholamine systems is evidently incompatible with the expression of playful behavior. 34. Bolanos CA, Barrot M, Berton O, Wallace-Black D, Nestler EJ (2003) Methylphenidate treatment during pre- and periadolescence alters behavioral responses to emotional stimuli at adulthood, Biological Psychiatry Dec 15;54(12):1317-29. Research with other mammals showing that pre- and periadolescents treated with Ritalin were significantly less responsive to natural rewards such as novelty-induced activity. They were also significantly more sensitive to stressful situations, and showed increased anxiety-like behaviours and enhanced levels of corticosterone in later life. Moll GH, Hause S, Ruther E, Rothenberger A, Huether G (2001) Early methylphenidate administration to young rats causes a persistent reduction in the density of striatal dopamine receptors, Journal of Child and Adolescent Psychopharmacology Spring;11(1):15-24. Research showing that when Ritalin was given to pre-pubescent rats they showed life-long reductions in brain dopamine activity. (Ritalin causes too much strain on the developing dopamine system in the child’s brain.) Early methylphenidate administration to young rats causes a persistent reduction in the density of striatal dopamine transporters. Nocjar C, Panksepp J (2002) Chronic intermittent amphetamine pretreatment enhances future appetitive behaviour for drug- and natural-reward: interaction with environmental variables. Behavioural Brain Research 22 Jan;128(2):89-203. Research showing that Ritalin can lead to an increased probability of addiction to cocaine in later life. 35. Panksepp J, Burgdorf J, Turner C, Gordon N (2003) Modeling ADHD-type arousal with unilateral frontal cortex damage in rats and beneficial effects of play therapy, Brain and Cognition. Research showing that play may produce a brain state comparable to that induced by low doses of psychostimulants, which is more conducive to behavioural inhibition and heightened attention. 36. Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford. Part 111, Rough-and-Tumble Play: The Brain Sources of Joy: 280. Further key studies for this chapter Taneja V, Beri RS, Puliyel JM (2004) Play in orphanages, Indian Journal of Pediatrics, Apr;71(4):297-99. Research showing that in orphanages the development of children rises dramatically after programmes of play are introduced. Himelstein J, Newcorn JH, Halperin JM (2000) The neurobiology of attention-deficit hyperactivity disorder, Front Bioscience Apr 1;5:461-78. Research supporting evidence of dysfunction of the dopaminergic and noradrenergic circuits in the frontal lobe in ADHD, with resulting deficits in cognitive functioning. Nocjar C, Panksepp J (2002) Chronic intermittent amphetamine pretreatment enhances future appetitive behaviour for drug- and natural-reward: interaction with environmental variables, Behavioural Brain Research 22 Jan;128(2):189-203. Ritalin as increasing the probability of addiction to cocaine in later life. CHAPTER FIVE: BEHAVING BADLY 1. Zhong X, Hilton HJ, Gates GJ, Jelic S, Stern Y, Bartels MN, Demeersman RE, Basner RC (2005) Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation, Journal of Applied Physiology Jun;98(6):2024-32. 2. Alvarez GG, Ayas NT (2004) The impact of daily sleep duration on health: a review of the literature, Progress in Cardiovascular Nursing Spring;19(2):56-59. Research showing that lack of sleep activates the sympathetic nervous system and causes impairment in glucose control. Zohar D, Tzischinsky O, Epstein R, Lavie P (2005) The effects of sleep loss on medical residents’ emotional reactions to work events: a cognitive-energy model, Sleep Jan 1;28(1):47-54. Sleep loss intensified negative emotions and fatigue following daytime disruptive events. Vgontzas AN, Bixler EO, Lin HM, Prolo P, Mastorakos G, Vela-Bueno A, Kales A, Chrousos GP (2001) Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pituitary-adrenal axis: clinical implications, The Journal of Clinical Endocrinology and Metabolism Aug;86(8):3787-94. 3. “Research by J. Michael Murphy, of the Department of Psychiatry at Harvard Medical School, documents that a school breakfast improves academic performance, psychological well-being, and behavior … A lack of breakfast took a heavy toll emotionally. Non-breakfast-eaters were twice as apt to be depressed and four times as apt to have anxiety. They were also 30 percent more likely to be hyperactive and to have a variety of psychological problems compared with consistent breakfast eaters. Moreover, Dr. Murphy’s investigations showed that kids who went from rarely eating to often eating breakfast had big upswings in academic performance. Such youngsters also became significantly less depressed, anxious, and hyperactive.” Carper J (2000) Your Miracle Brain, Harper Collins, New York: 113-14. 4. Teves D, Videen TO, Cryer PE, Powers WJ (2004) Activation of human medial prefrontal cortex during autonomic responses to hypoglycemia, Proceedings of the National Academy of Sciences of the United States of America Apr 20;101(16):6217-21. Research showing that hypoglycemia can result in increases of heart rate and adrenaline levels. 5. Richardson AJ, Montgomery P (2005) The Oxford-Durham study: a randomized, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder, Pediatrics 1115; 1360-66. Researchers saw improvements in reading, spelling and behaviour in children when they were given regular fish oil supplements. In total, 100 children took the full course of supplements. There are a number of signs that someone might be lacking in essential fatty acids. These include poor concentration, memory problems, depression, excessive mood swings, anxiety, difficulty sleeping, and problems with reading (because the letters and words appear to move or blur). Omega-3 fatty acids cannot be made by your body. Your entire supply of these fatty acids has to come from the foods you eat. They can be found in walnuts, peanuts, linseed oil, rapeseed oil, soya oil, and green leafy vegetables (e.g spinach). (Source: “Health News – Fish Oils boost children’s brains”, www.bupa.co.uk) Innis SM (2000) The role of dietary n-6 and n-3 fatty acids in the developing brain, Developmental neuroscience Sep-Dec;22(5-6):474-80. Recent studies have provided evidence that plasma docosahexaenoic acid (DHA) is available to the developing brain and that DHA is involved in dopamine and serotonin metabolism. These findings should guide clinical studies to more sensitive measures of the functional roles of dietary n-3 fatty acids and to clinical conditions where n-3 fatty acids may have benefit. Wainwright PE (2002) Dietary essential fatty acids and brain function: a developmental perspective on mechanisms, The Proceedings of the Nutrition Society Feb: 61-69. Fish oil influences the dopamine systems in the frontal lobe. Deficiency in fish oils impairs performance. Some studies suggest that dietary docosahexaenoic acid (DHA) may play a role in some neurodevelopmental disorders. 6. Boris M, Mandel FS (1994) Foods and additives are common causes of the attention deficit hyperactive disorder in children, Annals of allergy May;72(5):462-28. Research showing a beneficial effect of eliminating artificial colours from the food intake of children who tend to be hyperactive. Dietary factors may play a significant role in the etiology of the majority of children with ADHD. Tuormaa TE (1994) The adverse effects of food additives on health with a special emphasis on childhood hyperactivity, Journal of Orthomolecular Medicine 9(4):225-43. Feingold BF (1976) Hyperkinesis and learning disabilities linked to the ingestion of artificial food colours and flavours, Journal of Learning Disabilities 9: 19-27. Feingold BF (1981) Dietary management of behaviour and learning disabilities. In Miller SA (Ed) Nutrition & Behaviour, Franklin Institute Press, Philadelphia, Pennsylvania: 37. In what is known as the Feingold hypothesis, Dr Benjamin F. Feingold, M.D. (Chief Emeritus, Allergy Department, Kaiser Permanente Hospital, San Francisco) found that in some people, artificial food dyes can produce behavioural problems. After collecting evidence based on over 1,200 cases, he and his team found that hyperactivity, including other neuropsychological disturbances, can be induced in some children when they consume certain chemicals, such as food additives. He arrived at this conclusion by observing that certain children, who seemed to react neurophysiologically to aspirin, reacted in a similar way to natural foods containing salicylates. 7. One in five parents think it is OK to smack a toddler for throwing a tantrum. One in ten parents believe that it is OK to smack a toddler for refusing to get into their buggy. 87 percent of parents in the UK shout at their children. (All National Society for Prevention of Cruelty to Children (NSPCC), UK, 2003.) 8. See Stewart I, Jones V (1987) T.A. Today, Lifespace, Nottingham. 9. “To be able to effect something is the assertion that one is not impotent, but that one is an alive functioning human being ... It is, in the last analysis, the proof that one Is.” Fromm E (1973) The Anatomy of Human Destructiveness, Cape, London: 31. “There is a basic human need to have an effect upon others and the environment, to be seen, to make our mark on the world. And if I have no effect, I can easily feel I don’t exist – which is an unbearable feeling. The principle can be formulated thus; I am because I effect …” Fromm E. (1973) op. cit.: 31. 10. Hariri AR, Bookheimer SY, Mazziotta JC (2000) Modulating emotional responses: effects of a neocortical network on the limbic system, Neuroreport Jan 17;11(1):43-48. Research showing how stress regulation through verbal reflection and reasoning can modulate and control primitive feelings, and diminish activation in the amygdala. 11. Denham SA, Workman E, Cole PM, Weissbrod C, Kendziora KT, Zahn-Waxler C (2000) Prediction of externalizing behavior problems from early to middle childhood: the role of parental socialization and emotion expression, Development and Psychopathology Winter;12(1):23-45. Research showing that parental anger predicted the continuation of antisocial behaviour problems in children over time. Stuewig J, McCloskey LA (2005) The relation of child maltreatment to shame and guilt among adolescents: psychological routes to depression and delinquency, Child Maltreatment Nov;10(4):324-36. Results showed that harsh parenting in childhood was related to shame-proneness in adolescence. Furthermore, shame-proneness was associated with higher depression. Aunola K, Nurmi JE (2005) The role of parenting styles in children’s problem behavior, Child Development Nov-Dec;76(6):1144-59. Research showing that a high level of psychological control exercised by mothers, combined with high affection, predicted increases in the levels of both internal and external problem behaviors among children. Brody GH, Shaffer DR (1982) Contributions of parents and peers to children’s moral socialization, Developmental Review 2: 31-75. Research showing that punishment-based discipline had an adverse effect on moral socialization, regardless of age. 12. Haley DW, Stansbury K (2003) Infant stress and parent responsiveness: regulation of physiology and behavior, Child Development Sep-Oct;74(5):1534-46. Research showing that emotionally responsive parents can regulate a child’s body arousal system. Barbas H, Saha S, Rempel-Clower N, Ghashghaei T (2003) Serial pathways from primate prefrontal cortex to autonomic areas may influence emotional expression, Neuroscience Oct 10;4(1):25. Research describing top-down pathways from the frontal lobe to the subcortical area of the brain (including the hypothalamus, amygdala, and brain stem). These pathways show speedy influence of the prefrontal cortex on the autonomic system when a person is experiencing strong feelings. Rosenfeld P, Gutierrez YA, Martin AM, Mallett HA, Alleva E, Levine S (1991) Maternal regulation of the adrenocortical response in preweanling rats, Physiology & Behavior Oct;50(4):661-71. Research showing that maternal regulation is involved in the regulation of the responsiveness of the infant’s hypothalamic-pituitary-adrenal (HPA) system. 13. “The SEEKING system promotes states of eagerness and directed purpose in both humans and animals. The system’s dopamine circuits tend to energize and coordinate the functions of many higher brain areas that mediate planning and foresight.” Panksepp J (1998) Affective Neuroscience, Oxford University Press, New York: 54. 14. Gunnar MR (1989) Studies of the human infant’s adrenocortical response to potentially stressful events, New Directions for Child Development Fall (3-18). Times of quiet and silence in infants can be associated with larger elevations in cortisol than times of crying. Hertsgaard L, Gunnar M, Erikson MF, Nachmias, M. (1995) Adrenocortical responses to the strange situation in infants with disorganized / disorientated attachment relationships, Child Development 66: 1100-06. 15. Panksepp J (2003) Neuroscience: feeling the pain of social loss, Science Oct 10;302(5643):237-39. 16. Pollak SD (2005) Maternal regulation of infant reactivity, Developmental Psychology Summer;17(3):735-52. Research showing that when an infant was in distress, holding, rocking and vocalization were most effective at reducing all levels of distress. Distraction was related to an increased duration of crying during deep distress. Other studies have shown distraction can be effective before a child moves into deep distress. 17. Adamec RE (1991) Partial kindling of the ventral hippocampus: identification of changes in limbic physiology which accompany changes in feline aggression and defense, Physiology & Behavior Mar;49(3):443-53. Adamec, at the University of Newfoundland, kindled the RAGE system in some mammals. His research established that whilst it was possible to activate RAGE in an animal with no trouble, this very easily became established as a personality trait. The worry was that he couldn’t change the animal back to become non- angry! “The mere experience of an emotion without the capacity for [thinking] may tend to ingrain the aroused emotion as an [emotional] disposition in the brain …” Panksepp J (2001) The long-term psychobiological consequences of infant emotions – prescriptions for the twenty-first century, Infant Mental Health Journal Jan-Apr;22(1-2):145. CHAPTER SIX: TRYING TIMES 1. “As the cortex develops, vast numbers of top down neural networks connect with the subcortical area. These top down networks provide the information pathway for inhibiting reflexes and bringing subcortical functions under cortical control. Thus, a vital aspect of the development of the cortex is the inhibitory …” Cozolino LJ (2002) The Neuroscience of Psychotherapy: Building and Rebuilding the Human Remain, W.W. Norton & Company, London: 76. “The orbitofrontal system matures in the last half of the 2nd year, a watershed time for the appearance of a number of adaptive capacities. These advances reflect the role of the frontal lobes in the development of infant self-regulatory behavior …” Schore AN (1997) Early organisation of the non-linear right brain and development of a predisposition to psychiatric disorders, Development and Psychopathology 9, 595-631: 607. 2. Panksepp J (1993) “Rough and Tumble Play: A Fundamental brain process”. In MacDonald KB (Ed) (1993) Parents and Children Playing, SUNY Press, Albany NY: 147-184. Research showing that if mammalian infants are deprived of social play, they will make up for lost time and play all the harder. “Young mammals appear to have a neurobiological need to play that ‘builds up’ if it is not dissipated.” Pellegrini A, Davis Huberty P, Jones I (1996) The effects of recess timing on children’s playground and classroom behaviours, American Educational Research Journal 32(4):845-64. This study shows that children who were deprived of playtime at school developed ADHD-type symptoms. 3. “Intense interest, engaged curiosity and eager anticipation are the types of feelings that reflect arousal of this SEEKING system in humans …” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 149. “These dopamine circuits tend to energise and coordinate the functions of many higher brain areas that mediate planning and foresight …” Panksepp J (1998) op. cit.: 54. “… the mammalian brain contains a foraging/ exploration/ investigation/ curiosity/ interest/ expectancy/ SEEKING system that leads organisms to eagerly pursue the fruits of their environment – from nuts to knowledge so to speak.” Panksepp J (1998) op. cit.: 145. 4. Spangler G, Schieche M, Ilg U, Maier U, Ackermann C (1994) Maternal sensitivity as an external organizer for biobehavioral regulation in infancy, Developmental Psychobiology Nov;27(7):425-37. The effect of maternal sensitivity on adrenocortical function in infants during free play was demonstrated at 3 and 6 months. The findings indicate the importance of maternal behavior for infant biobehavioral organization. Feldman R, Greenbaum CW, Yirmiya N (1999) Mother-infant affect synchrony as an antecedent of the emergence of self-control, Developmental Psychology Jan;35(1):223-31. Research showing that the regulation of emotion in infancy (including face-to-face play and child-led play) is an important contributor to the emergence of self-regulation. 5. Uvnas-Moberg K, Petersson M (2005) Oxytocin, a mediator of anti-stress, well-being, social interaction, growth and healing, Zeitschrift fur Psychosomatische Medizin und Psychotherapie 51(1):57-80. (Article is in German.) Research showing that oxytocin is a mediator of stress relief and well-being. It can reduce blood pressure and cortisol levels. It can also stimulate various types of positive social interaction. Caldji C, Diorio J, Meaney MJ (2003) Variations in maternal care alter GABAA receptor subunit expression in brain regions associated with fear, Neuropsychopharmacology 28: 1950-59. Research with other mammals showing that high levels of touch in infancy resulted in a far less fearful response in later life. Research also showed that comforting maternal behaviour has a profound influence on GABA gene expression in the infant’s brain, thus enabling infants to be less vulnerable to developing anxiety disorders in later life. 6. Gordon N, Burke S, Akil H, Watson S, Panksepp J (2003) Socially-induced brain “fertilization”: play promotes brain derived neurotrophic factor transcription in the amygdala and dorsolateral frontal cortex in juvenile rats, Neuroscience Letters 24 Apr;341(1):17-20. Research showing that social play can increase the activation of a vital brain fertilizer called brain derived neurotrophic factor (BDNF), which helps to programme the higher brain regions involved in regulating emotional behaviours (e.g. helps children to manage their feelings better). There was higher gene expression in the frontal lobes when children had been playing: “The dorsolateral frontal cortex had significantly elevated BDNF expression as a result of play”. 7. Zubieta JK, Ketter TA, Bueller JA, Xu Y, Kilbourn MR, Young EA, Koeppe RA (2003) Regulation of human affective responses by anterior cingulate and limbic and m-opioid neurotransmission, General Psychiatry Nov;60(11):1037-1172. Research showing that sustained sadness is associated with deactivation of m-opioid neurotransmission in the anterior cingulate gyrus, and in the amgydala and the temporal cortex. This correlates to an increase in negative feelings and reduction in positive feelings. The opioid system is involved in the physiological regulation of affective states and regulation of emotional pain – so opioid withdrawal can be followed by fear, emotional pain, and stress. 8. For other creative ways of dealing with provocative behaviour, see Hughes, D (1998) Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children, Jason Aronson, New Jersey. 9. Faber A, Mazlish E (1998) Siblings Without Rivalry, Collins, New York. 10. Newson J, Newson E (1970) Seven Years old in the Home Environment, Penguin Books, UK. 11. Pennebaker JW (1993) Putting stress into words: health, linguistic, and therapeutic implications, Behaviour Research and Therapy Jul;31(6):539-48. 12. Parker J, Stimpson J (2002) Sibling rivalry, sibling love: What every brother and sister needs their parents to know, Hodder & Stoughton, UK. 13. Hariri AR, Bookheimer SY, Mazziotta JC (2000) Modulating emotional responses: effects of a neocortical network on the limbic system, Neuroreport Jan 17;11(1):43-48. Research showing that stress regulation through verbal reflection can modulate and control primitive feelings, and diminish activation in the amygdala. 14. Moseley J (1996) Quality Circle Time, Cambridge: LDA. CHAPTER SEVEN: ALL ABOUT DISCIPLINE 1. Research on parental behaviour, Smith M et al (1997), Thomas Coram Research Unit, Institute of Education, University of London. 2. Shea A, Walsh C, Macmillan H, Steiner M (2005) Child maltreatment and HPA axis dysregulation: relationship to major depressive disorder and post traumatic stress disorder in females, Psychoneuroendocrinology Feb;30(2):162-78. The development of the hypothalamic-pituitary-adrenal (HPA) axis, which is involved in stress regulation, can be affected by stressful experiences in early life. Child maltreatment can lead to dysregulation of the HPA axis, which in turn can lead to later onset of major psychiatric disorders. 3. Teicher M (2002) Scars that won’t heal, Scientific American, March. Teicher MH, Andersen SL, Polcari A, Anderson CM, Navalta CP, Kim DM (2003) The neurobiological consequences of early stress and childhood maltreatment, Neuroscience and Biobehavioral Reviews Jan-Mar;27(1-2):33-44. Teicher M, Anderson S, Polcari A (2002) Developmental neurobiology of childhood stress and trauma, The Psychiatric Clinics of North America 25: 297-426. DeBellis MD (2001) Developmental traumatology: the psychobiological development of maltreated children and its implications for research, treatment and policy, Development and Psychopathology 13: 539-564. 4. Van der Kolk B (1989) The compulsion to repeat the trauma: re-enactment, revictimization, and masochism, Psychiatric Clinics of North America 12: 389-411. Research showing that violent criminals are often simply repeating in their crimes the traumas and humililations of their childhood. Gilligan J (1996) Violence: Our Deadly Epidemic and Its Causes, G. P. Putnam’s Sons, New York: 93. “[People disciplined in harsh ways as children] can grow up as emotionally [damaged] adults and become vengeful time bombs who periodically restage their early traumas in sacrificial rites called wars …” (Examples might include Saddam Hussein, Hitler, and Ceaucescu.) De Mause L (2002) The Emotional Life of Nations, Karnac Books, New York: Vii. “The routine … domination of children has been society’s most effective instrument of collective emotional homeostasis … History needn’t repeat itself; only the traumas demand repetition.” De Mause L (2002), op. cit.: 97 “There is no question that if the world could treat children with helping-mode parenting, wars and all other self-destructive social conditions we still suffer from in the twenty-first century will be cured, simply because the world will be filled with individuated personalities who are empathic towards others and who are not self-destructive. A world that loves and trusts its children and encourages them to develop their unique selves will be a world of very different institutions, a world without wars, jails, and other domination group-fantasies”. De Mause L (2002) op. cit.: 430-31. “Each generation begins anew with fresh, eager, trusting faces of babies, ready to love and create a new world. And each generation of parents … dominates its children until they become emotionally crippled adults who repeat in nearly exact detail the social violence and domination that existed in previous decades. Should a minority of parents … begin to provide somewhat more secure, loving early years that allow a bit more freedom and independence, history soon begins to move in surprising new directions and society changes in innovative ways.” De Mause L (2002) op. cit.: 97. 5. Oliner S, Oliner P (1988) The Altruistic Personality: Rescuers of Jews in Nazi Europe, The Free Press, New York. 6. Raine A, Meloy JR, Bihrle S, Stoddard J, Lacasse L, Buchsbaum MS (1998) Reduced prefrontal and increased subcortical brain functioning assessed using positron emission tomography in predatory and affective murderers, Behavioural Sciences and the Law 16: 319-32. 7. Troy M, Sroufe LA (1987) Victimisation among preschoolers: role of attachment relationship history, Journal of American Academy of Child and Adolescent Psychiatry 26: 166-72. Research showing how children under the age of five who had known submission / dominance modes of interaction in their home environments were already acting out victim / persecutor scenes in their play. 8. “The mere experience of an emotion without the capacity for [thinking] may tend to ingrain the aroused emotion as an [emotional] disposition in the brain …” Panksepp J (2001) The long-term psychobiological consequences of infant emotions – prescriptions for the twenty-first century, Infant Mental Health Journal Jan-Apr;22(1-2):145. Hoffman ML (1994) Discipline and internalization, Developmental Psychology 30: 26-28. Research showing that whilst empathy facilitates moral socialization, fear actually hinders it. 9. Cline F, Facy J (1990) Parenting with Love and Logic, Pinon Press, Colorado Springs. 10. Brody GH, Shaffer D R (1982) Contributions of parents and peers to children’s moral socialization, Developmental Review 2: 31-75. Research showing that punishment-based discipline had an adverse effect on moral socialization regardless of age. 11. Weninger O (1998) Time-In Parenting Strategies, esf Publishers, New York. 12. Frost J (2005) Supernanny, Hodder & Stoughton, London. See also some excellent discipline techniques to facilitate higher brain development in Byron T, Baveystock S (2003) Little Angels, BBC Worldwide Learning, London. 13. Hariri AR, Bookheimer SY, Mazziotta JC (2000) Modulating emotional responses: effects of a neocortical network on the limbic system, Neuroreport Jan 17;11(1):43-48. Research showing how stress regulation through verbal reflection and reasoning can modulate and control primitive feelings, and can diminish activation in the amygdala. Pennebaker JW (1993) Putting stress into words: health, linguistic, and therapeutic implications, Behaviour Research and Therapy Jul;31(6):539-48. Fossati P, Hevenor SJ, Graham SJ, Grady C, Keightley ML, Craik F, Mayberg H (2003) In search of the emotional self: an FMRI study using positive and negative emotional words, The American Journal of Psychiatry Nov;160(11):1938-45. Research showing that a widely distributed network of brain areas contributes to emotional processing. By providing a personal perspective in the evaluation of emotional stimuli, the right dorsomedial prefrontal cortex may mediate cognitive processes that guide the self-regulation of emotional experience. 14. Philips A (1999) Saying No, Faber and Faber, London. 15. Gentle, safe holding is appropriate in schools if a child is hurting either him- or herself or others, or is damaging property, and is so incensed and out of control that all verbal attempts to engage the child have failed. Such necessary interventions are fully in line with guidelines set out in the United Kingdom government document “New Guidance on the Use of Reasonable Force in School” (DfEE 1998) or Section 550a, Education Act 1996. CHAPTER EIGHT: CHEMISTRY OF LOVE 1. Nelson EE, Panksepp J (1998) Brain substrates of infant-mother attachment: contributions of opioids, oxytocin, and norepinephrine, Neuroscience and Biobehavioral Reviews May;22(3):437-52. Research demonstrating that oxytocin and opioids are part of social motivation circuitry between mother and child. “… brain oxytocin, opioids and prolactin systems appear to be the key participants in these subtle feelings that we humans calls acceptance, nurturance and love – the feelings of social solidarity and warmth. Although many human interactions and cognitive experiences also contribute to maternal states, without the underlying mood- and behaviour-altering neuropeptides, those experiences would probably remain shallow and without emotional intensity …” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 249. 2. “Animals prefer to spend more time with other animals in whose presence they have experienced high brain oxytocin and opioid activities. Thus it seems as if friendships are cemented by the same chemical systems that mediate maternal and sexual urges. Perhaps this is one of the primitive emotional reasons why we are more likely to help family and friends than strangers (a phenomenon called kin selection by sociobiologists) …” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 237. 3. “The chemistries that promote pleasure and family values are also able to dramatically reduce irritability and aggressiveness.” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 257. Kalin NH, Shelton SE, Lynn DE (1995) Opiate systems in mother and infant primates coordinate intimate contact during reunion, Psychoneuroendocrinology 20(7):735-42. Research demonstrating that intimate contact between parent and child results in reciprocal activation of their opioid systems. 4. “Research shows that in the animal kingdom, the strongest, more revered animals are not the ones who are the greatest fighters; they are the ones with the highest levels of oxytocin and opioids.” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford; 293. Research “suggests that brain opioids control social emotionality, so that without brain opioids an animal tends to feel psychologically weaker, causing it to lose because it is more prone to experience negative feelings such as separation distress …” Panksepp J (1998) op. cit.: 285. “Play-dominance studies suggest that brain opioids may increase feelings of ‘social strength’ …” Panksepp J (1998) op. cit.: 293. 5. Carter CS (1998) Neuroendocrine perspectives on social attachment and love, Psychoneuroendocrinology Nov;23(8):779-881. Insel TR (1992) Oxytocin: a neuropeptide for affiliation, Psychoneuroendocrinology 17:3-35. 6. Panksepp J, Jalowiec J, DeEskinazi FG, Bishop P (1999) Opiates and play dominance in juvenile rats, Behavioral Neuroscience Jun;99(3):441-53. 7. McCarthy MM (1990) Oxytocin inhibits infanticide in wild female house mice, Hormones & Behaviour 24: 365-75. 8. Dawson G, Frey K, Panagiotides H, Yamada E, Hessl D, Osterling J (1999) Infants of depressed mothers exhibit atypical frontal electrical brain activity during interactions with mother and with a familiar nondepressed adult, Child Development Sep-Oct;70(5):1058-66. Research showing reduced activation in the child’s left frontal lobe as a result of non-responsive parent. (The left frontal lobe activates positive feelings and social approval behaviour.) This may predispose these children to depression in later life. Dawson G, Frey K, Self J, Panagiotides H, Hessi D, Yamada E, Rinaldi J (1999) Frontal brain electrical activity in infants of depressed and non-depressed mothers; relation to variations in infant behaviour, Development and Psychopathology Summer;11(3):589-605. Research showing that infants of depressed mothers had reduced left frontal brain activity, which was found to be related to lower levels of affection towards mother, higher level of negative affect, hostility, and tantrums and aggression. 9. For the CARE system, see Panksepp J (1998) Affective Neuroscience, Oxford University Press, New York, Chapter 13: Love and the Social Bond. 10. Aitken KJ, Trevarthen C (1997) Self/other organisation in human psychological development, Development and Psychopathology 9: 653-77. Research demonstrating that babies are genetically programmed to be able to enter into dialogue with face, voice, gesture, and body movements. Trevarthen C, Aitken KJ (2001) Infant intersubjectivity: research, theory, and clinical applications, Journal of Child Psychology and Psychiatry, and Allied Disciplines Jan;42(1):3-48. Research showing babies “wired up” for dialogue from day one. Trevarthen C (1993) “The Self born in intersubjectivity: the psychology of an infant communicating”. Cited in Neisser U (Ed.) The Perceived Self: Ecological and Interpersonal Sources of Self-knowledge, Press Syndicate of the University of Cambridge, Cambridge: 123. 11. Orbach S (2004) The Body in Clinical Practice. Part One: There’s no such thing as a body; Part Two: When touch comes to therapy. John Bowlby Memorial Lecture in Touch, Attachment and the Body. White K (Ed.) Karnac Books, London. 12. See Montagu A (1971) Touching: The Human Significance of the Skin, Harper and Row, London. Prescott JW (1971) Early somatosensor deprivation as an ontogenetic process in the abnormal development of brain and behaviour; in Goldsmith EI, Mody-Janokowski J (Eds) Proceedings of the Second Conference on Experimental Medicine and Surgery in Primates, Karger, Basel: 356-75. 13. Adapted from Winnicott DW (1971) Playing and Reality, Penguin/Basic, London/New York. Winnicott was a famous child psychoanalyst. 14. Jernberg AM, Booth PB (2001) Theraplay: Helping parents and children build better relationships through attachment-based play, Jossey-Bass, San Francisco. Lots of these games were created by Phyllis Booth. With Jernberg, she designed a way of being with children which duplicated those delightful one-to-ones that parents have with their babies. This gives children who have missed out on this vital brain sculpting stage a second chance. 15. Schore A (2003) Affect Regulation and the Repair of the Self, W.W. Norton & Company, New York: 158-74. Schore A (1996) The experience-dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of development psychopathology, Development and Psychopathology 8: 59-87. Main M, Weston DR (1982) “Avoidance of the attachment figure in infancy. Descriptions and interpretations.” In Parkes CM, Stevenson-Hinde J (Eds), The Place of attachment in human behaviour, Basic Books, New York: 31-59. 16. Jenner S (1999) The parent-child game, Bloomsbury, London. These diagnostic categories of child-led play and parent-led play have been adapted from Sue Jenner’s Parent-child play. 17. The concept of the parent who becomes the child’s favourite toy, by rising to the bait of a child’s provocative behaviour and responding with a firework display of angry behaviour comes from this excellent book: Glasser H, Easley J (1999) Transforming the Difficult Child, Nurtured Heart, New York. 18. Hughes D (2005) Working with Troubled Children, Lecture Centre for Child Mental Health, London; citing Buber M (1987) I and Thou, T and T Clark, Edinburgh. 19. “Opioids and oxytocin are bonding chemistries. Dopamine does not appear as important in bonding …” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 260. 20. Tronick EZ (1989) Interactive Repair, emotions and emotional communication in infants, The American Psychologist Feb;44(2):112-19. Positive development may be associated with the experience of parent-child interactions characterized by frequent reparations of interactive errors and the transformation of negative affect into positive affect, whereas negative development appears to be associated with sustained periods of interactive failure and negative affect. Butovskaya ML, Boyko EY, Selverova NB, Ermakova IV (2005) The hormonal basis of reconciliation in humans, Journal of Physiological Anthropology and Applied Human Science Jul;24(4):333-37. Research showing that the stress-reduction role of peacemaking was supported on the physiological level. The level of stress-related hormones was higher when no reunion occurred. 21. Hughes D (1998) Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children, Jason Aronson, New Jersey. See this book for more exquisite responses to challenging behaviour in children in ways that activate the higher brain rather than the lower brain. 22. “Since the joy of loving seems hopelessly barred to him, he may as well deliver himself over to the joy of hating and obtain what satisfaction he can out of that.” Fairbairn WRD (1940) “Schizoid Factors in the Personality”; in Psychoanalytic Studies of the Personality (1952), Tavistock/Routledge, London: 27. Fromm E (1973) Anatomy of Human Destructiveness, Cape, London. 23. Field T (1994) The effects of mother’s physical and emotional unavailability on emotion regulation, Monographs of the Society for Research in Child Development 59;(2-3):208-27. Research demonstrating that the mother’s still face had more negative effects on the infants’ interaction behaviour than the physical separation. Maternal depression can affect a child’s physiology, cortisol levels, sleep, eating, toileting, and the immune system. Researchers suggest these changes occur because the infant is being chronically deprived of an important external regulator of stimulation (the mother) and thus fails to develop emotion regulation and physiological rhythm. Haley DW, Stansbury K (2003) Infant stress and parent responsiveness: regulation of physiology and behavior during still-face and reunion, Child Development Sep-Oct;74(5):1534-46. Research demonstrating that emotionally responsive parents can regulate a child’s heart rate. The unresponsive mother’s face elicited a cortisol response in the child. Thus the infants of more responsive parents showed greater regulation of heart rate and negative affect. 24. Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 255. 25. Zubieta JK, Ketter TA, Bueller JA, Xu Y, Kilbourn MR, Young EA, Koeppe RA (2003) Regulation of human affective responses by anterior cingulate and limbic and m-opioid neurotransmission, General Psychiatry Nov;60(11):1037-1172. Research demonstrating that sustained sadness is associated with deactivation of opioid neurotransmission in the anterior cingulated gyrus, and in the amgydala and the temporal cortex. This increases negative feelings and reduces positive feelings. The activation of opioids is important for reducing feelings of fear and stress. The anterior cingulate gyrus has also been implicated in pain activation, a function that is also regulated by m-opioid receptors. “Separation despair ‘activates’ the brain CRF system ... followed by a depletion of brain noradrenalin, serotonin and certain dopamine reserves … Indeed depressive symptoms by animals and humans can be evoked experimentally by establishing these types of physiological changes in the body. For instance, prolonged administration of CRF along with depletion of the biogenic amines [e,g. dopamine] can promote depressive responses …” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 276. 26. Goodall J (1990) Through a Window: Thirty Years with the Chimpanzees of Gombe, Weidenfeld & Nicolson, London. 27. Some of the Rwanda children in the orphanage, after the grief of losing their parents, gave up and died. Glover J (2001) Humanity: A moral history of the twentieth century, Pimlico, London. 28. Armstrong-Perlman EM (1991) The allure of the bad object, Free Associations 2 (3)23: 343-56. 29. Weininger O (1989) Children’s Phantasies: The Shaping of Relationships, Karnac Books, London. Weininger O (1993) View from the Cradle: Children’s Emotions in Everyday Life, Karnac Books, London. 30. Eisenberger NI, Lieberman MD, Williams KD (2003) Does rejection hurt? An FMRI study of social exclusion, Science Oct 10;302(5643):290-92. Research demonstrating how a feeling of rejection on the outside activates the anterior cingulate cortex, which registers physical pain, and that psychological pain parallels physical pain. 31 Personal communication (2004) “Children’s feeling language is their behaviour”, Jay Vaughan Family Futures Consortium, London. 32. This understanding that children need help to speak about feelings, and so adopting an “imagining in” approach like this and speaking as the child, can be found richly and extensively in the superb book Hughes, D (1998) Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children, Jason Aronson, New Jersey. CHAPTER NINE: YOUR SOCIALLY INTELLIGENT CHILD 1. Steele M, Steele H, Johansson M (2002) Maternal predictors of children’s social cognition: an attachment perspective, Journal of Child Psychology and Psychiatry, and Allied Disciplines Oct;43(7):861-72. Studies show that eleven-year-olds who responded well to another child’s feelings were significantly more likely to have had parents who responded well to theirs. 2. “As the cortex develops, vast numbers of top down neural networks connect with the subcortical area. These top down networks provide the information pathway for inhibiting reflexes and bringing subcortical functions under cortical control. Thus, a vital aspect of the development of the cortex is the inhibitory. This theory is supported by the effects of cortical damage in adults. Individuals with Alzheimer’s disease, for example, experience significant cell death in their cortex.” Cozolino LJ (2002) The Neuroscience of Psychotherapy: Building and Rebuilding the Human Remain, W.W. Norton & Company, London: 76. 3. Bar-On R, Tranel D, Denburg NL, Bechara A (2003) Exploring the neurological substrate of emotional and social intelligence, Brain Aug;126(8):1790-800. Research showing that subjects with emotional and social intelligence abilities show activation in the ventromedial (VM) prefrontal cortex. Those with damage here have poor judgment in decision-making and choices in their relationships. 4. Critchley HD, Daly EM, Bullmore ET, Williams SC, Van Amelsvoort T, Robertson DM, Rowe A, Phillips M, McAlonan G, Howlin P, Murphy DG (2000) The functional neuroanatomy of social behaviour: changes in cerebral blood flow when people with autistic disorder process facial expressions, Brain Nov;123(11):2203-12. Research showing that subjects with autistic disorder differed significantly from controls in the activity of cerebellar, mesolimbic, and temporal lobe cortical regions of the brain when processing facial expressions. They did not activate a cortical “face area” when explicitly appraising expressions, or the left amygdala region and left cerebellum when implicitly processing emotional facial expressions. McKelvey JR, Lambert R, Mottron L, Shevell MI (1995) Right-hemisphere dysfunction in Asperger’s syndrome, Journal of Child Neurology Jul;10(4):310-14. Research showing that cerebellar abnormalities were present, alongside other brain structure abnormalities, in subjects with Asperger’s syndrome. McAlonan GM, Daly E, Kumari V, Critchley HD, van Amelsvoort T, Suckling J, Simmons A, Sigmundsson T, Greenwood K, Russell A, Schmitz N, Happe F, Howlin P, Murphy DG (2002) Brain anatomy and sensorimotor gating in Asperger’s syndrome, Brain Jul;125(Pt 7):1594-606. Research in autism shows differences in processing facial expressions. Notably, people with autism did not activate a cortical “face area” when explicitly appraising expressions, or the left amygdala region and left cerebellum when implicitly processing emotional facial expressions. 5. Rosenblum LA, Coplan JD, Friedman S, Bassoff T, Gorman JM, Andrews MW (1994) Adverse early experiences affect noradrenergic and serotonergic functioning in adult primates, Biological Psychiatry Feb 15;35(4):221-27. Research demonstrating that early relational stress can alter the development of noradrenalin and serotonin systems, causing susceptibility to adult anxiety and emotional disorders. Dolan M, Deakin WJF, Roberts N, Anderson I (2002) Serotonergic and cognitive impairment in impulsive aggressive personality disorder offenders: are there implications for treatment? Psychological Medicine, 32: 105-17. “Serotonin supplementation can decrease aggression in animals that have become irritable because of long-term social isolation. In general reduced brain serotonin activity also tends to increase impulsive and acting out forms of behaviour in humans.” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 202. 6. Kotulak R (1996) Inside the Brain: Revolutionary Discoveries of How the Mind Works, Andrews and McMeel, Kansas City: 85. Kotulak cites a study at the National Institute of Alcohol Abuse and Alcoholism – studying monkeys with low serotonin levels. These animals were found to be both impulsive and aggressive. “… given the opportunity, they will make dangerous leaps from tree to tree that other monkeys won’t attempt. They get into frequent fights.” “Serotonin supplementation can decrease aggression in animals that have become irritable because of long-term social isolation. In general reduced brain serotonin activity also tends to increase impulsive and acting out forms of behaviour in humans.” Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 202. “We know that children who have come from angry or violent backgrounds often show lower levels of serotonin” Institute of Juvenile Research Chicago; cited by Kotulak R (1996) Inside the Brain: Revolutionary Discoveries of How the Mind Works, Andrews and McMeel, Kansas City: 85. 7. Murray L, Andrews L (2000) The social baby: Understanding babies’ communication from birth, CP Publishing, Richmond, London. 8. Bar-on ME (1999) Turning off the television, British Medical Journal 24;318(7191):1152. 9. Stern DN (1985) The Interpersonal World of the Infant, Basic Books, New York. Stern DN (1990) Diary of a Baby - What Your Child Sees, Feels, and Experiences, Basic Books, New York. 10. Kanner L (1943) Autistic disturbance of affective contact, Nervous Child 2 217-350. 11. The Mifne Center, PO Box 112, Rosh Pinna 12000, Israel www.mifne-autism.com Director: Hanna Alonim. 12. De Bellis MD, Keshavan MS, Spencer S, Hall J (2000) N-acetylaspartate concentration in the anterior cingulate of maltreated children and adolescents with PTSD, The American Journal of Psychiatry July; 157: 1175-77. Research demonstrating that maltreatment of children may be associated with brain structural alterations. The anterior cingulate neuronal metabolism may be altered in childhood maltreatment, with possible cell death in this region. Together with damage to the corpus callosum and other brain structures, this may lead to impairments in psychosocial and cognitive functioning. Devinsky O, Morrell MJ, Vogt BA (1995) Contributions of anterior cingulate cortex to behaviour, Brain Feb;118(Pt 1):279-306. Research shows that malfunctions in the anterior cingulate can cause a lack of compassion. Posner MI, Rothbart MK (1998) Attention, self-regulation and consciousness, Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, Nov 29;353(1377):1915-27. During childhood, the activation of cingulated structures links to parental reports of self-regulation and emotional control. These studies indicate a start in understanding the anatomy, circuitry and development of executive attention networks that serve to regulate both cognition and emotion. 13. Blair RJ, Colledge E, Murray L, Mitchell DG (2001) A selective impairment in the processing of sad and fearful expressions in children with psychopathic tendencies, Journal of Abnormal Child Psychology Dec 29 (6): 491-98. The study investigates the sensitivity of children with psychopathic tendencies to facial expressions. The children with psychopathic tendencies presented with selective impairments; they needed significantly more stages before they could successfully recognize the sad expressions, and even when the fearful expressions were at full intensity were significantly more likely to mistake them for another expression. These results are interpreted with reference to an amygdala and empathy impairment explanation of psychopathy. Blair RJ (1995) A cognitive developmental approach to mortality: investigating the psychopath, Cognition Oct 57 (1): 1-29. Research showing that social animal species have been noted to inhibit aggressive attacks when a conspecific displays submission cues. Blair (1993) has suggested that humans possess a functionally similar mechanism, which mediates the suppression of aggression in the context of distress cues. This is thought to be a prerequisite for the development of social and moral intelligence. Psychopaths may lack this violence inhibitor. Pollak SD, Cicchetti D, Hornung K, Reed A (2000) Recognizing emotion in faces: developmental effects of child abuse and neglect, Developmental Psychology Sep;36(5):679-88. Main M, Goldwyn R (1984) Predicting rejection of her infant from mother’s representation of her own experience: implications for the abused – abusing intergenerational cycle, Child Abuse and Neglect 8: 203-17. Research showing that maltreated toddlers show marked deficits in the ability to show empathy and respond positively toward other toddlers in distress. Pollak SD, Cicchetti D, Hornung K, Reed A (2000) Recognizing emotion in faces: developmental effects of child abuse and neglect, Developmental Psychology 36: 679-88. Research showing that children who have suffered lack of sensitive and meaningful interactions with parents show vastly impoverished capacities for recognizing and understanding emotion. Maltreated toddlers show marked deficits in the ability to show empathy and respond positively towards other toddlers in distress (Main and Goldwyn 1984). 14. See Panksepp J (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford – Chapter 13, Love and the Social Bond: 250. 15. Teicher MH, Ito Y, Glod CA, Andersen SL, Dumont N, Ackerman E (1997) Preliminary evidence for abnormal cortical development in physically and sexually abused children using EEG coherence and MRI, Annals of the New York Academy of Sciences 821: 160-75. Teicher MH, Andersen SL, Polcari A, Anderson CM, Navalta CP, Kim DM (2003) The neurobiological consequences of early stress and childhood maltreatment, Neuroscience and Biobehavioral Reviews Jan-Mar;27(1-2):33-44. “We are finding that verbal abuse is devastating … These changes [to the brain] are devastating … An underdeveloped corpus callosum inhibits communication between one hemisphere and the other. As a result children could end up ‘residing’ in one hemisphere rather than moving rapidly and easily from one to the other.” Martin Teicher (2000) Wounds that time won’t heal: the neurobiology of child abuse, Cerebrum, Fall. From press release, “McLean researchers document brain damage linked to child abuse and neglect”, McLean Hospital, Belmont, MA. 16. Teicher M (2002) Scars that won’t heal, Scientific American Mar;286(3):68-75. De Bellis MD, Keshavan MS, Shifflett H, Iyengar S, Beers SR, Hall J, Moritz G (2002) Brain structures in pediatric maltreatment-related posttraumatic stress disorder: a sociodemographically matched study, Biological Psychiatry Dec 1;52(11):1066-78. Research demonstrating that children with PTSD had smaller prefrontal cortex, smaller right temporal lobe volume, smaller volume of the corpus callosum, and larger frontal lobe cerebrospinal fluid volume than control subjects. De Bellis, MD, Keshavan, MS, Spencer S, Hall J (2000) N-acetylaspartate concentration in the anterior cingulate of maltreated children and adolescents with PTSD, The American Journal of Psychiatry Jul;157:1175-77. Researchers’ previous studies showed that childhood PTSD leads to a smaller volume in terms of the corpus callosum and frontal lobe. In this study, researchers found neuronal loss following severe stress in childhood and suggested that this may contribute to the pathogenesis of PTSD and other impairments in psychosocial and cognitive functioning. 17. See Siegel DJ (1999) The Developing Mind, The Guildford Press, New York. One of the best texts on the differences between the left and right frontal brain, and on their communication and blocked communication. 18. van Goozen SH, Snoek H, Matthys W, van Rossum I, van Engeland H (2004) Evidence of fearlessness in behaviourally disordered children: a study on startle reflex modulation, Journal of Child Psychology and Psychiatry, and Allied Disciplines. May;45(4):884-92. Research demonstrating neurophysiological fearlessness (lower startle responses to unpleasant things) in delinquent children. Blair RJ (2001) Neurocognitive models of aggression, the antisocial personality disorders, and psychopathy, Journal of Neurology, Neurosurgery, and Psychiatry Dec;71(6):727-31. Research showing that problems in executive emotional systems in the brain in the orbitofrontal cortex are related to sociopathy. This includes incapacity to form associations around distress cues. 19. Troy M, Sroufe LA (1987) Victimization among preschoolers: role of attachment relationship history, Journal of American Academy of Child and Adolescent Psychiatry 26: 166-72. 20. Blair RJ, Budhani S, Colledge E, Scott S (2005) Deafness to fear in boys with psychopathic tendencies, Journal of Child Psychology and Psychiatry, and Allied Disciplines Mar;46(3):327-36. Research showing reduced responsiveness to the expressions of sadness and fear has been implicated in the development of psychopathy (Blair, 1995). Boys with this sort of reduced responsiveness couldn’t recognize that there was fear in a voice. This state is linked to amygdala dysfunction. 21. Singer T, Seymore B, O’Doherty J, Kaube H, Dolan RJ, Frith CD (1994) Empathy for pain involves the affective but not sensory components of pain, Science Feb (303). Research showing the crucial role of anterior cingulate gyrus for empathic experience related to pain. 22. Teicher MH, Andersen SL, Polcari A, Anderson CM, Navalta CP, Kim DM (2003) The neurobiological consequences of early stress and childhood maltreatment, Neuroscience and Biobehavioral Reviews Jan-Mar;27(1-2):33-44. Early severe stress produces a cascade of neurobiological events that have the potential to cause enduring changes in brain development. The major structural consequences of early stress include reduced size of the mid-portions of the corpus callosum and attenuated development of the left neocortex, hippocampus, and amygdala. Teicher MH, Ito Y, Glod CA (1996), “Neurophysiological mechanisms of stress response in children”. In Pfeffer CR (Ed) Severe stress and mental disturbances in children, American Psychiatric Press, Washington, DC: 59-84. Teicher M, Anderson S, Polcari A (2002) Developmental neurobiology of childhood stress and trauma, The Psychiatric Clinics of North America 25: 297-426. DeBellis MD, Baum AS, Birmaher B, Kevesham MS, Eccard CH, Boring AM, et al. (1999) Developmental traumatology. Part 1; Biological stress symptoms, Biological Psychiatry 45: 1235-36. 23. Caldji C, Diorio J, Meaney MJ (2003) Variations in maternal care alter GABAA receptor subunit expression in brain regions associated with fear, Neuropsychopharmacology 28: 1950-59. Research demonstrating how maternal care can adversely or positively effect gene expression of GABAA receptors in the brain, hence underlining the well-established relationship between stressful events in early life and vulnerability for anxiety disorders in later life. 24. Schore A (2005) Attachment, affect regulation and the right brain: linking developmental neuroscience to pediatrics, Pediatrics in Review 26 (6) June. 25. Teicher M (2002) Scars that won’t heal, Scientific American Mar;286(3):68-75. 26. Straus MA, Gelles RJ, Steinmetz SK (1980) Behind Closed Doors: Violence in the American Family, Anchor Books, Garden City, NJ. Research showing that almost all American children are violent towards their brothers and sisters. It was found that 83% of boys and 74% of girls attacked a brother or sister; 59% of boys and 46% of girls attacked a brother or sister severely. 27. Schore A (2003) Affect Dysregulation and Disorders of the Self, W.W. Norton & Company, New York: 26. 28. Weinberg I (2000) The prisoners of despair: right hemisphere deficiency, Neuroscience and biobehavioral reviews Dec;24(8):799-815. Research showing that because emotional pain is largely registered by the right brain, a compensatory shift to the left frontal lobe can be an unconscious defence to cut off from painful feelings and move into lower sensitivity to pain. Sierra M, Senior C, Dalton J, McDonough M, Bond A, Phillips ML, O’Dwyer AM, David AS (2002) Autonomic response in depersonalization disorder, Archives of General Psychiatry Sep; 59 (9): 833-38. Research shows that in people who are emotionally cut off, the autonomic response to unpleasant stimuli is reduced. Hence there can be a selective inhibitory mechanism on emotional processing. Lowen A (1975) Bioenergetics, Penguin Books, London. CHAPTER TEN: LOOKING AFTER YOU 1. de Weerth C, van Hees Y, Buitelaar JK (2003) Prenatal maternal cortisol levels and infant behavior during the first 5 months, Early Human Development Nov: 139-51. Research demonstrating that high cortisol levels in late pregnancy are related to more difficult temperament, and more crying, fussing and negative facial expressions in the baby during the first five months. The few studies that have looked at the infants’ later development have found prenatal stress to be related to more difficult temperament, behavioral/emotional problems, and poorer motor/cognitive development. Deminiere JM, Piazza PV, Guegan G, AB (1992) Increased locomotor response to novelty and propensity to intravenous amphetamine self-administration in adult offspring of stressed mothers, Brain Research Jul 17;586(1):135-39. Research demonstrating that prenatal stress may contribute to an individual’s vulnerability to move into drug-seeking in later life. Watterberg KL (2004) Adrenocortical function and dysfunction in the fetus and neonate, Seminars in Neonatology Feb: 13-21. Research demonstrating that the fetus is exposed to very low concentrations of cortisol until late in gestation. Perturbations of the intra-uterine environment resulting in fetal exposure to increased cortisol may have consequences not only in infancy, but also into adult life. Buitelaar JK, Huizink AC, Mulder EJ, de Medina PG, Visser GH (2003) Prenatal stress and cognitive development and temperament in infants, Neurobiology of Aging May-Jun Suppl 1: S53-60; discussion S67-8. Research demonstrating that increased maternal stress during pregnancy seems to be one of the determinants of delayed development in infants and may be a risk factor for developing psychopathology later in life. Gorman JM, Mathew S, Coplan J (2002) Neurobiology of early life stress: nonhuman primate models, Seminars in Clinical Neuropsychiatry Apr 7: 96-103. Research demonstrating that prenatal stress can alter regulation of the hypothalamic-pituitary-adrenal (HPA) axis, biogenic amines, and immune function, as well as affect behavioral measures of attention and sociability. Field T, Diego M, Hernandez-Reif M, Salman F, Schanberg S, Kuhn C, Yando R, Bendell D (2002) Prenatal anger effects on the fetus and neonate, Journal of Obstetrics and Gynaecology May: 260-66. For women who experienced high anger during pregnancy (and who also had high scores on depression and anxiety), high prenatal cortisol and adrenaline and low dopamine and serotonin levels in the second trimester were mimicked by their neonates’ high cortisol and low dopamine levels and low vagal tone. The newborns of the high-anger mothers had disorganized sleep patterns and showed signs of depression. Field T, Diego M, Hernandez-Reif M, Schanberg S, Kuhn C (2002) Relative right versus left frontal EEG in neonates, Developmental Psychobiology. Sep: 147-55. Research demonstrating that the newborns of mothers with lower prenatal and postnatal serotonin and higher postnatal cortisol levels had the greater relative right frontal EEG activation ( associated with negative feeling) and lower vagal tone. The higher the babies’ cortisol levels, the greater the number of changes in sleep/wake behaviour, and the more depressive and excitable the symptoms. Therefore, it is good to target pregnant women for prenatal intervention. Van der Kolk B, Saporta J (1991) The biological response to psychic trauma: mechanisms and treatment of intrusion and numbing, Anxiety Research 4: 199-212. Research demonstrating how trauma in utero or during birth can leave an infant hypersensitive to stress, fearful, withdrawn, or angry on a long-term basis. This is due to the trauma causing chemical imbalances in the brain. Fride E, Weinstock M (1988) Life Sciences: 1059-65. Prenatal stress increases anxiety-related behaviour and alters cerebral lateralization of dopamine activity. Buitelaar JK, Huizink AC, Mulder EJ, de Medina PG, Visser GH (2003) Prenatal stress and cognitive development and temperament in infants, Neurobiology of Aging May-Jun: S53-60; discussion S67-68. Research demonstrating that increased maternal stress during pregnancy seems to be one of the determinants of delayed development in infants and may be a risk factor for developing psychopathology later in life. Glover V (1999) Maternal stress or anxiety during pregnancy and the development of the baby, The Practising Midwife May: 20-22. Research showing that anxious mothers had impaired blood flow through the uterine arteries. This may help to explain why the babies of very anxious mothers tend to be smaller or born earlier. There was also a strong correlation between levels of the stress hormone cortisol in the mother and in the fetus. Slykerman RF, Thompson JM, Pryor JE, Becroft DM, Robinson E, Clark PM, Wild CJ, Mitchell EA (2005) Maternal stress, social support and preschool children’s intelligence, Early Human Development Oct: 815-21. Research showing that in the total sample, maternal stress and lack of social support during pregnancy was significantly associated with lower intelligence test scores in the children. In children who were smaller than normal at birth, maternal stress post-pregnancy was significantly associated with lower intelligence test scores. Kinnunen AK, Koenig JI, Bilbe G (2003) Repeated variable prenatal stress alters pre- and postsynaptic gene expression in the rat frontal pole, Journal of Neurochemistry Aug: 736-48. Research demonstrating that stress in pregnancy is a risk factor for a child developing schizophrenia due to significant changes in key genes in the fetal brain. Maternal stress during critical periods of fetal brain development reprogrammes the response of the HPA axis to acute stress. 2. McNamara ME, Burnham DC, Smith C, Carroll DL (2003) The effects of back massage before diagnostic cardiac catheterization, Alternative Therapies in Health and Medicine Jan-Feb: 50-57. Research demonstrating that massage reduces psychological distress, and brings down blood pressure. Field T, Hernandez-Reif M, Hart S, Theakston H, Schanberg S, Kuhn C, Burman I (1999). Pregnant women benefit from massage therapy, Journal of Psychosomatic Obstetrics and Gynecology: 31-38. Research demonstrating how massage in pregnancy decreased anxiety and stress hormones. 3. Williams MT, Davis HN, McCrea AE, Hennessy MB (1999) Stress during pregnancy alters the offspring’s hypothalamic, pituitary, adrenal, and testicular response to isolation on the day of weaning, Neurotoxicology and Teratology, Nov-Dec;21(6):653-59. “It is now well established that mother rats who have been heavily stressed during pregnancy tend to have a high incidence of homosexual male offspring. Maternal stress sets in motion internal neurochemical changes that tend to leave the brains of male offspring in their primordial femalelike condition.” Panksepp, J. (1998) Affective Neuroscience: The Foundations of Human and Animal Emotions, Oxford University Press, Oxford: 237. 4. Floyd RL, O’Connor MJ, Sokol RJ, Bertrand J, Cordero JF (2005) Recognition and prevention of fetal alcohol syndrome, Obstetrics and Gynecology Nov 106(5):1059-64. Research showing that fetal alcohol syndrome is characterized by specific facial abnormalities and significant impairments in neurodevelopment and physical growth. Bookstein FL, Connor PD, Covell KD, Barr HM, Gleason CA, Sze RW, McBroom JA, Streissguth AP (2005) Preliminary evidence that prenatal alcohol damage may be visible in averaged ultrasound images of the neonatal human corpus callosum, Alcohol Jul 36(3):151-60. 5. Wakschlag LS, Lahey BB, Loeber R, Green SM, Gordon RA, Leventhal BL (1997) Maternal smoking during pregnancy and the risk of conduct disorder in boys, Archives of General Psychiatry July: 670-76. Research demonstrating that mothers who smoked more than half a pack of cigarettes daily during pregnancy were significantly more likely to have a child with conduct disorder than mothers who did not smoke during pregnancy. Smoking was associated with adverse reproductive outcomes, including altered neural structure and functioning, cognitive deficits, and behaviour problems in male offspring. Fergusson DM, Woodward LJ, Horwood LJ (1998) Maternal smoking during pregnancy and psychiatric adjustment in late adolescence, Archives of General Psychiatry Aug: 721-27. Research from an 18-year longitudinal study shows that children exposed to maternal smoking during pregnancy had higher psychiatric symptom rates for conduct disorder, alcohol abuse, substance abuse, and depression. 6. M’bailara K, Swendsen J, Glatigny-Dallay E, Dallay D, Roux D, Sutter AL, Demotes-Mainard J, Henry C (2005) Baby blues: characterization and influence of psycho-social factors (article in French), Encephale May-June: 331-36. The baby blues seems to be a physiological process whereby the intensity and rapid mood swings are influenced by psychological factors. Consequently the diminution of self-esteem with motherhood and the increase of stress in relation to the care of the baby appeared to be significant factors in the intensity of the baby blues. Halligan SL, Herbert J, Goodyer IM, Murray L (2004) Exposure to postnatal depression predicts elevated cortisol in adolescent offspring, Biological Psychiatry Feb 15: 376-81. Research showing that adolescents still being affected by maternal postnatal depression had higher, more variable morning cortisol levels (a predictor of depression). Field T (1994) The effects of mother’s physical and emotional unavailability on emotion regulation, Monographs of the Society for Research in Child Development 59(2-3):208-27. Research demonstrating that maternal depression can affect a child’s physiology, cortisol levels, sleep, eating, toileting, and the immune system. These are the effects of the mother’s physical and emotional unavailability on her vital role as emotional regulator. Dawson G, Klinger LG, Panagiotides H, Hill D, Spieker S (1992) Frontal lobe activity and affective behavior of infants of mothers with depressive symptoms, Monographs of the Society for Research in Child Development Jun: 725-37. Research showing that infants aged 11-17 months with depressed mothers showed less activity in the frontal brain (the part of the brain specialized for approach emotions) during playful interactions with their mothers. They also showed less distress during maternal separation. Buss KA, Schumacher JR, Dolski I, Kalin NH, Goldsmith HH, Davidson RJ (2003) Right frontal brain activity, cortisol, and withdrawal behavior in 6-month-old infants, Behavioral Neuroscience Feb: 11-20. Research demonstrating that withdrawn behaviour in 6-month-old infants was associated with extreme right brain activation and higher cortisol levels. Ashman SB, Dawson G, Panagiotides H, Yamada E, Wilkinson CW (2002) Stress hormone levels of children of depressed mothers, Development and Psychopathology Spring: 333-49. Research suggests that disruptions in early care can have long-term effects on the hypothalamic-pituitary-adrenal (HPA) axis, which mediates the stress response. Halligan SL, Herbert J, Goodyer IM, Murray L (2004) Exposure to postnatal depression predicts elevated cortisol in adolescent offspring, Biological Psychiatry Feb: 376-81. Research demonstrating that maternal postnatal depression was associated with alterations in cortisol levels in the children. Thus early life experiences may alter steroid levels in later life, causing a risk of depression in adulthood. 7. Heinrichs M, Meinlschmidt G, Neumann I, Wagner S, Kirschbaum C, Ehlert U, Hellhammer DH (2001) Effects of suckling on hypothalamic-pituitary-adrenal axis responses to psychosocial stress in postpartum lactating women, The Journal of Clinical Endocrinology and Metabolism Oct: 4798-804. Both breast-feeding and holding the infant yielded significant decreases in ACTH, total plasma cortisol, and salivary free cortisol (all P < 0.01). 8. In one study conducted at Harvard Medical School and the U.S.D.A. Human Nutrition Research Center at Tufts University, more than one out of every four depressed patients was deficient in vitamins B6 and B12. In fact, vitamin B6 deficiency is reported in as many as 79 percent of patients with depression, compared to only 29 percent of other patients. In many cases, giving these patients vitamin B6 supplements (in doses as low as 10 milligrams a day) raises vitamin B6 levels in the blood and improves or even alleviates the depression providing convincing evidence that the deficiency might be the cause, rather than the effect, of the depression. Cited in Somer E (1999) Food and Mood, Henry Holt, New York. 9. Prasad C (1998) Food, mood and health: a neurobiological outlook, Brazilian Journal of Medical and Biological Research Dec: 1517-27. Research showing that food may be used unconsciously to regulate mood; manipulation of dietary preference is actually an attempt to correct neurochemical make-up. 10. Neki NS, Singh RB, Rastogi SS (2004) How brain influences neuro-cardiovascular dysfunction, The Journal of the Association of Physicians of India Mar: 223-30. Research showing that saturated and total fat and sedentary behaviour can enhance sympathetic activity and increase the secretion of cortisol, whereas omega-3 fatty acid supplementation may enhance parasympathetic activity. Sympathetic activity can have adverse effects on heart rate and blood pressure, while increased parasympathetic activity has beneficial effects and can inhibit sympathetic tone. Wainwright PE (2002) Dietary essential fatty acids and brain function: a developmental perspective on mechanisms, The Proceedings of the Nutrition Society Feb: 61-69. Fish oil influences the dopamine systems in the frontal lobe. Deficiency in fish oils impairs performance. Some studies suggest that dietary docosahexaenoic acid (DHA), an essential fatty acid, may play a role in cognitive development as well as in some neurodevelopmental disorders; this possibility has important implications for population health. 11. “Just about every measure of thinking ability improves after eating a good breakfast – from math scores and creative thinking to speed and efficiency in solving problems, concentration, recall, and accuracy in work performance. Compared to breakfast skippers, people who eat breakfast communicate more effectively, make fewer mistakes, get the job done more quickly, and are more creative throughout the day …” Somer E (1999) Food and Mood, Henry Holt, New York: 195. 12. “Impressive new research by J. Michael Murphy, of the Department of Psychiatry at Harvard Medical School, documents that a school breakfast improves academic performance, psychological well-being, and behavior … A lack of breakfast took a heavy toll emotionally. Non-breakfast-eaters were twice as apt to be depressed and four times as apt to have anxiety. They were also 30 percent more likely to be hyperactive and to have a variety of psychological problems compared with consistent breakfast eaters. Moreover, Dr. Murphy’s investigations showed that kids who went from rarely eating to often eating breakfast had big upswings in academic performance. Such youngsters also became significantly less depressed, anxious, and hyperactive.” Carper J (2000) Your Miracle Brain, Harper Collins, New York: 113-14. 13. Benton D (2002) Selenium intake, mood and other aspects of psychological functioning, Nutritional Neuroscience Dec: 363-74. Research showing that a low selenium intake was associated with poorer mood. Shor-Posner G, Lecusay R, Miguez MJ, Moreno-Black G, Zhang G, Rodriguez N, Burbano X, Baum M, Wilkie F (2003) Psychological burden in the era of HAART: impact of selenium therapy, International Journal of Psychiatry in Medicine 33(1):55-69. Research showing that selenium intake was linked to less anxiety and increased vigour. 14. Seeman TE, McEwen BS (1996) Impact of social environment characteristics on neuroendocrine regulation, Psychosomatic Medicine Sep-Oct;58(5):459-71. Research demonstrating that supportive relationships can lower cortisol levels, whereas unsupportive interactions can cause enhanced reactivity in the hypothalamic-pituitary-adrenal (HPA) axis. Healthy social ties are therefore highly associated with health and longevity. Carter CS (1998) Neuroendocrine perspectives on social attachment and love, Psychoneuroendocrinology Nov;23(8):779-818. Research demonstrating how positive social behaviours, including social bonds, can reduce HPA axis activity, whilst negative social interactions have the opposite effect. Oxytocin is implicated in both social bonding and the central control of the HPA axis and in the regulating of the autonomic nervous system. 15. Szabo A, Peronnet F, Boudreau G, Cote L, Gauvin L, Seraganian P (1993) Psychophysiological profiles in response to various challenges during recovery from acute aerobic exercise, International Journal of Psychophysiology May: 285-92. Research demonstrating higher levels of dopamine and noradrenaline after exercise. 16. See Uvnas-Moberg K (2003) The Oxytocin Factor, Da Capo Press, Cambridge MA; this excellent book is by the world’s leading expert on oxytocin. 17. Sahasi G, Mohan D, Kacker C (1989) Effectiveness of yogic techniques in the management of anxiety, Journal of Personality and Clinical Studies 5: 51-55. Research demonstrating that yoga was more effective than diazepam in alleviating anxiety. 18. Takahashi T, Murata T, Hamada T, Omori M, Kosaka H, Kikuchi M, Yoshida H, Wada Y (2005) Changes in EEG and autonomic nervous activity during meditation and their association with personality traits, International Journal of Psychophysiology Feb: 199-207. Research showing that meditation can increase vagal tone and calm the ANS. Blackwell B, Bloomfield S, Gartside P, Robinson A, Hanenson I, Magenheim H, Nidich S, Zigler R (1976) Transcendental meditation in hypertension. Individual response patterns, Lancet 1: 223-26. Research demonstrating that meditation reduced blood pressure and anxiety. Jevning R, Wilson AF, Davidson JM (1978) Adrenocortical activity during meditation, Hormones & Behavior 10: 54-60. Cortisol is reduced in people who meditate on a long-term basis. Field T, Seligman S, Scafidi F, Schanberg S (1996) Alleviating posttraumatic stress in children following Hurricane Andrew, Journal of Applied Developmental Psychology: 37-50. Research demonstrating that subjects with severe PTSD were happier, less anxious and had lower salivary cortisol levels after massage therapy, and had lower scores in anxiety and depression. Platania-Solazzo A. Field TM, Blank J, Seligman F, Kuhn C, Schanberg S, Saab P (1992) Relaxation therapy reduces anxiety in child and adolescent psychiatric patients, Acta Paedopsychiatrica: 115-20. Research demonstrating decreases in anxiety and cortisol levels, and increases in positive feeling, from massage and yoga. Jones N, Field T (1999) Right frontal EEG asymmetry is attenuated by massage and music therapy, Adolescence: 529-34. Research shows that brief sessions of massage therapy and music therapy were noted to shift the EEG of depressed mothers from greater relative right frontal activation (a pattern associated with depression) to symmetry. Field T, Grizzle N, Scafidi F, Schanberg S (1996) Massage and relaxation therapies’ effects on depressed adolescent mothers, Adolescence 31: 903-11. Research demonstrating that depressed teenage mothers were less depressed and anxious after massage. Their cortisol levels were lower and serotonin levels were higher. 19. House JS, Landis KR, Umberson D (1988) Social relationships and health, Science Jul 29;241(4865):540-45. Research linking isolation and poor-quality social relationships with increased risk of death. 20. Arborelius L, Owens MJ, Plotsky PM, Nemeroff CB (1999) The role of corticotrophin-releasing factor in depression and anxiety disorders, The Journal of Endocrinology Jan;160(1):1-12. Kathol RG, Jaeckle RS, Lopez JF, Meller WH (1989) Pathophysiology of HPA axis abnormalities in patients with major depression: an update, The American Journal of Psychiatry Mar;146(3):311-17. Plotsky PM, Owens MJ, Nemeroff CB (1998) Psychoneuroendocrinology of depression. Hypothalamic-pituitary-adrenal axis, The Psychiatric Clinics of North America Jun;21(2):293-307. Research demonstrating that in depression there is a dysfunction of the HPA axis, presenting as elevation of cortisol and CRF levels. Dunman RS, Heninger GR, Nestler EJ (1997) A molecular and cellular theory of depression, Archives of General Psychiatry Jul: 597-606. Research demonstrating that the stress of depression can decrease the expression of brain derived neurotrophic factor (BDNF), and lead to cell death in the hippocampus. Anti-depressants lead to increased expression of BDNF. Malphurs J, Raag T, Field T, Pickens J, Pelaez-Nogueras M (1996) Touch by intrusive and withdrawn mothers with depressive symptoms, Early Development and Parenting: 111-15. Research showing that mothers with depressive symptoms were more likely to touch their infants in a negative way or an intrusive way. Dawson G, Ashman SB, Panagiotides H, Hessl D, Self J, Yamada E, Embry L (2003) Preschool outcomes of children of depressed mothers: role of maternal behavior, contextual risk, and children’s brain activity, Child Development Jul-Aug: 1158-75. Infants of depressed mothers exhibit behavioral disturbances and atypical frontal brain activity. Dawson G, Frey K, Panagiotides H, Yamada E, Hessl D, Osterling J (1999) Infants of depressed mothers exhibit atypical frontal electrical brain activity during interactions with mother and with a familiar, nondepressed adult, Child Development Sep-Oct: 1058-66. Infants of depressed mothers exhibited reduced left relative to right frontal activity. Dawson G, Frey K, Self J, Panagiotides H, Hessl D, Yamada E, Rinaldi J (1999) Frontal brain electrical activity in infants of depressed and nondepressed mothers: relation to variations in infant behavior, Development and Psychopathology Summer: 589-605. Infants of depressed mothers showed less affection and touching of their mothers. Reduced left frontal brain activity was found to be related to lower levels of affection towards mother, but not to infant temperament. 21. Hibbs ED, Zahn TP, Hamburger SD, Kruesi MM, Rapoport JL (1992) Parental expressed emotion and psychophysiological reactivity in disturbed and normal children, The British Journal of Psychiatry Apr;160:504-10. Research demonstrating how children are adversely affected physiologically by parents with high levels of expressed dysregulated feeling (e.g anger]). Ashman SB, Dawson G, Panagiotides H, Yamada E, Wilkinson CW (2002) Stress hormone levels of children of depressed mothers, Development and Psychopathology Spring;14(2):333-49. Research demonstrating that children of depressed mothers had higher levels of stress chemicals. Maternal depression during the child’s first 2 years of life was still showing up as high levels of cortisol when the child was 7. This suggests the maternal depression in the first 2 years of life may be responsible for a child’s high level of cortisol in later life. Dawson G, Ashman SB, Panagiotides H, Hessl D, Self J, Yamada E, Embry L (2003) Preschool outcomes of children of depressed mothers: role of maternal behaviour, contextual risk, and children’s brain activity, Child Development Jul-Aug;74(4):1158-75. Research demonstrating that children of mothers with chronic depression exhibit lower frontal and parietal brain activation compared with children of mothers without depression. Leung C, Leung S, Chan R, Tso K, Ip F (2005) Child behaviour and parenting stress in Hong Kong families, Hong Kong Medical Journal Oct: 373-80. Parenting stress and children’s behaviour problems were associated with presence or absence of social support. 22. Rottenberg J, Wilhelm FH, Gross JJ, Gotlib IH (2003) Vagal rebound during resolution of tearful crying among depressed and nondepressed individuals, Psychophysiology Jan: 1-6. Research demonstrating that crying when you are not depressed is calming, restoring homeostasis in bodily arousal systems. Ishii H, Nagashima M, Tanno M, Nakajima A, Yoshino S (2003) Does being easily moved to tears as a response to psychological stress reflect response to treatment and the general prognosis in patients with rheumatoid arthritis? Clinical and Experimental Rheumatology. Sep-Oct: 611-16. Research showing that the capacity to cry is associated with better immune responses and preventing the build-up of stress. 23. Phelps JL, Belsky J, Crnic K (1998) Earned security, daily stress, and parenting: a comparison of five alternative models, Development and Psychopathology Winter: 21-38. Research showing that parents who have worked through their own childhood pain do not re-enact poor parenting practices with their own children. Other Studies Quinlan PT, Lane J, Moore KL, Aspen J, Rycroft JA, O’Brien DC (2000) Acute physiological and mood effects of tea and coffee: the role of caffeine level, Pharmacology, Biochemistry, and Behavior May: 19-28. Tea and coffee produces mild autonomic stimulation and an elevation in mood.