At Risk Youth

A community group in Redlands, Calif., is shifting its approach to underage drinking. Rather than informing young people about the dangers of drinking, the group is educating adults on the consequences of providing young people with alcohol.

“The RPC [Redlands Prevention Coalition] is working to create a ’social host’ ordinance in Redlands,” the Redlands Daily Facts newspaper reported. “The law could empower police to cite hosts of underage drinking parties with civil or criminal violations. Police could also levy fines for the cost of law enforcement services needed to enforce the ordinance against hosts who do not comply with the law.”

Other cities in the area have adopted similar laws and seen them work. The RPC is currently drafting legislation that it hopes to put in front of lawmakers soon.

New government rules that take effect July 1 should force insurance companies pay out more for treatments for mental diseases.

The new rules apply to people enrolled in group health plans from private employers or ones provided by state and local governments. The new rules will affect 140 million people, and increase insurance premiums by $25.6 billion over the next decade, according to government estimates. Businesses that employ under 50 people will be exempt.

The new rules provide that insurance companies cannot restrict coverage for diseases such as autism, schizophrenia, eating disorders, drug addiction, and alcoholism by limiting the number of hospital days and outpatient treatments.

Insurers can still require “prior approval and that a course of treatment is medically necessary.” However, insurance companies will no longer be able to require separate deductibles for medical/surgical expenses, and mental health/substance abuse charges. Policyholders would have a single deductible for both types of treatment.

“Patients with mental illness often have a general medical condition such as diabetes or high blood pressure that requires treatment at the same time,” said Irvin L. Muszynski, “which means that a combined deductible makes sense.” Muszynski is a lawyer with the American Psychiatric Association.

The new rules were developed by the Labor Department, the Department of Health and Human Services, and the Internal Revenue Service.

Even six-year-olds can develop school-related stress, according to a new study of Chinese children.

• Prof. Therese Hesketh of University College London studied 2191 children ages 6 to 12 years old.
• One-third of the students had stress-related symptoms, such as headaches and stomach aches.
• 80 percent worried about school exams, 66 percent were afraid their teachers would punish them.
• 75 percent feared their parents would punish them physically.

Many Chinese parents and teachers pressure children to compete for limited placements in universities, government jobs and graduate careers.

This study appeared in the British Medical Association’s Archives of Disease in Childhood.

Childhood trauma may cause some adults gain weight and have difficulty losing it, according to a new study of more than 17,000 patients in the Kaiser Permanente health system.

In 1987 Dr. Vincent Felitti studied 286 obese people in the Kaiser system and found that 50% had been sexually abused as children, a much higher rate than average. He decided to look into other kinds of childhood trauma that may be linked to overweight, and began to investigate previous studies.

• One study of more than 11,000 women found that those who had been abused as children were 27 percent more likely to be overweight.
• A study of 15,000 teenagers found that sexual childhood abuse in males raised their risk of obesity as adults to 66 percent.
• Dr. Felitti then began the Adverse Childhood Experience (ACE) study involving a database of over 17,000 Kaiser patients.

Dr. Felitti and his colleagues defined adverse experience as ongoing childhood neglect, living with one or no biological parent, having a mentally ill or drug addicted parent, having a parent in jail, witnessing domestic violence, and sexual, physical or emotional abuse. Children who had four or more of these experiences had double the risk of obesity, double the risk of heart attack and stroke, and four times the risk for emphysema.

Dr. Felitti and others believe that food is a comforting escape for abused children.

“Being fat is not the problem,” he said. “It’s the solution.”

What’s more troubling about the study is that some researchers believe that adverse experiences in childhood can lead to permanent biological changes in certain areas of the body, and that such changes are passed down from one generation to the next.

Children whose parents are depressed are more at risk for depression themselves. Now two new studies from Vanderbilt University indicate that family treatments for depression may lower a child’s risk.

The first study looked at two groups of adults with depression, and their children ages 9 to 15 years old. One group was assigned to cognitive behavioral therapy as a family unit. The other group used written materials that children and parents read on their own.

Children in the first group had half the incidence of depression compared to children in the second. The greatest benefits occurred a year after participation in the two kinds of therapy. The study appeared in the Journal of Consulting Clinical Psychology.

The second study found that cognitive behavioral therapy could help teenagers, but did not necessarily help parents with depression.

“We now have extremely encouraging evidence from two studies conducted at Vanderbilt, that we may be able to reduce the incidence of depression and other mental health problems in children at high risk,” said Prof. Bruce Compas.

The second study appeared in the Journal of the American Medical Association.

Young people with depression are more likely to do poorly in school and relationships, and they are at higher risk for substance abuse and suicide.