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<td><span style="font-family:Helvetica, sans-serif; font-size:20px;font-weight:bold;">PsyPost – Psychology News Daily Digest (Unofficial)</span></td>
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<td><a href="https://www.psypost.org/weight-gain-doesnt-appear-to-reduce-happiness/" style="font-family:Helvetica, sans-serif; letter-spacing:-1px;margin:0;padding:0 0 2px;font-weight: bold;font-size: 19px;line-height: 20px;color:#222;">Weight gain doesn’t appear to reduce happiness</a>
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<p><p>Does gaining weight make people less happy? According to new research published in the <em><a href="https://link.springer.com/article/10.1007/s41042-024-00203-z" target="_blank" rel="noopener">International Journal of Applied Positive Psychology</a></em>, the answer is generally no. Using a decade’s worth of data, a researcher in Germany found that weight gain does not negatively impact life satisfaction. In some cases, individuals who gained weight even reported slight increases in happiness, regardless of their gender or age, suggesting that weight’s psychological impact may be less significant than previously thought.</p>
<p>Overweight and obesity are major public health issues in Western societies, including Germany, where more than half the population is classified as overweight. While the adverse physical health consequences of being overweight are well-documented, its psychological impacts, particularly on happiness and life satisfaction, remain underexplored. <a href="https://scholar.google.com/citations?user=aDDn6vkAAAAJ&hl=de&oi=ao">Felix Bittmann</a> at the <a href="https://www.lifbi.de/en-us/Start/Institute/People/Person/account/2967">Leibniz Institute for Educational Trajectories</a> sought to determine whether weight gain directly influences happiness over time and to identify any causal mechanisms underlying this relationship.</p>
<p>“Obesity is a significant and growing problem in almost all modern societies,” explained Bittmann, a postdoctoral researcher. “It not only generates considerable costs for the health system, but also shortens life and therefore contributes to a great deal of unhappiness. The question for me was whether it is possible to quantify the effect of obesity on life satisfaction numerically based on high-quality panel data.”</p>
<p>To examine this, Bittmann used data from the German National Educational Panel Study (NEPS), which tracks a cohort of adults through annual surveys. The sample included 8,815 participants between the ages of 25 and 60, with data collected from 2011 to 2021. The study excluded individuals who were underweight or extremely obese to ensure results were not biased by outliers. Body mass index (BMI), calculated from self-reported weight and height, served as the measure of overweight and obesity. Happiness was assessed using a single-item question about life satisfaction, rated on a scale from 0 (completely dissatisfied) to 10 (completely satisfied).</p>
<p>Two statistical models were employed to analyze the data. First, fixed-effects regression models were used to isolate the within-person effects of weight changes on happiness. This method minimizes the influence of unchanging individual traits, such as personality or genetic predispositions, allowing for a clearer view of how BMI fluctuations affect life satisfaction over time. Second, a random-intercept cross-lagged panel model was applied to explore the temporal dynamics between BMI and happiness. This model examines whether changes in one variable (e.g., BMI) predict subsequent changes in the other (e.g., happiness) and vice versa.</p>
<p>Control variables included age, health, employment status, relationship status, and geographic region (East or West Germany). These factors were included to ensure that the observed effects of BMI on happiness were not confounded by other influences.</p>
<p>While descriptive analyses showed a slight negative correlation between BMI and happiness, this relationship disappeared—and in some cases reversed—when causal effects were examined. Specifically, weight gain was not associated with a decrease in happiness. For both men and women, increasing BMI was either unrelated to happiness or showed a slight positive effect. These findings were consistent across all age groups and BMI categories, including overweight and moderately obese individuals.</p>
<p>“Surprisingly, there is no evidence of a negative effect of obesity on life satisfaction,” Bittmann told PsyPost. “This is good insofar as this problem does not appear to directly affect the psyche. The indirect effects are of course still there, as people who are overweight have poorer health and shorter lifespans. In this respect, the study seems to me to be particularly relevant in demonstrating why so many people are overweight: it hardly burdens them psychologically, which is why they have little incentive to lose the excess weight.”</p>
<p>For example, men who moved from a BMI of 22 (high-normal) to 30 (obese) experienced a small but statistically significant increase in happiness. Similarly, women’s happiness levels plateaued after reaching a BMI of 27 and showed no decline with further weight gain.</p>
<p>These conclusions were supported by the random-intercept cross-lagged panel model, which confirmed that changes in BMI did not lead to subsequent decreases in happiness. In fact, the model suggested a small, reciprocal relationship, where increases in happiness were associated with slight increases in BMI and vice versa. Although the effects were minor, they highlight the absence of the expected negative impact of weight gain on well-being.</p>
<p>“Not being able to detect any negative effects of overweight or obesity on happiness was very surprising to me, but the results are very robust and not a single analysis or model could find any negative effect in a longitudinal setting,” Bittmann noted.</p>
<p>One of the study’s primary limitations is its reliance on self-reported height and weight to calculate BMI. BMI is widely used, but it is an imperfect measure of health and weight-related outcomes. It does not account for differences in body composition, such as the ratio of muscle to fat, which could influence both health and happiness. Additionally, life satisfaction was only measured once a year, preventing any analysis of short-term fluctuations.</p>
<p>“Perhaps being overweight has a negative impact on satisfaction, but then possibly only for a short time, until people have become accustomed to the weight,” Bittmann said. “To measure these small and short-term effects, you would have to survey people much more often, which is costly.”</p>
<p>The findings raise questions about the societal and psychological factors that influence the relationship between weight and happiness. For instance, the growing body-positivity movement may play a role in mitigating the negative social stigma associated with being overweight. Alternatively, the slight positive effects observed could reflect the enjoyment of food or the comfort of avoiding restrictive diets. Future research should investigate these potential mechanisms in more detail, as well as explore how cultural and individual attitudes toward weight influence well-being.</p>
<p>“One of my research interests lies generally in what makes people happy or unhappy in the long term for guidance and, maybe, political interventions or advice,” Bittmann said.</p>
<p>The study, “<a href="https://doi.org/10.1007/s41042-024-00203-z" target="_blank" rel="noopener">The Scale Goes Up, the Joy Goes Down? Investigating the Causal Effect of Body Weight on Happiness</a>,” was published November 25, 2024.</p></p>
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<td><a href="https://www.psypost.org/scientists-show-how-common-sleep-aid-disrupts-brains-natural-cleaning-process/" style="font-family:Helvetica, sans-serif; letter-spacing:-1px;margin:0;padding:0 0 2px;font-weight: bold;font-size: 19px;line-height: 20px;color:#222;">Scientists show how common sleep aid disrupts brain’s natural cleaning process</a>
<div style="font-family:Helvetica, sans-serif; text-align:left;color:#999;font-size:11px;font-weight:bold;line-height:15px;">Jan 26th 2025, 06:00</div>
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<p><p>Scientists have discovered that rhythmic oscillations of a specific neurotransmitter play a vital role in clearing toxic proteins from the brain during non-rapid eye movement (non-REM) sleep. These oscillations drive the glymphatic system by powering the coordinated movement of cerebrospinal fluid and blood. However, the commonly prescribed sleep aid zolpidem (commonly marketed as Ambien) disrupts this process, potentially impairing the brain’s ability to clear waste. The findings have been published in the journal <em><a href="https://www.cell.com/cell/abstract/S0092-8674(24)01343-6" target="_blank" rel="noopener">Cell</a>.</em></p>
<p>The glymphatic system is a network in the brain responsible for clearing waste products, such as amyloid and tau proteins, which are associated with neurodegenerative diseases like Alzheimer’s. Unlike other organs, the brain lacks traditional lymphatic vessels for waste removal. Instead, it relies on cerebrospinal fluid (CSF) to flush out toxins through specialized spaces surrounding blood vessels.</p>
<p>“When we started this study, we already knew that the glymphatic system is vital for cleaning the brain, that it relies on brain fluid (CSF) flushing through the brain, and that it is activated during sleep. However, we did not know how sleep was driving the removal of waste from the brain,” explained Natalie Hauglund, the first author of the study and currently a postdoctoral fellow at the University of Oxford.</p>
<p>The researchers conducted a series of experiments on mice to observe the glymphatic system in action during sleep.</p>
<p>The first set of experiments focused on how norepinephrine, a neurotransmitter that regulates arousal and blood vessel constriction, interacts with cerebral blood flow and CSF movement during sleep. Using “flow fiber photometry,” a technique that allows real-time tracking of norepinephrine levels, blood flow, and CSF dynamics, the researchers found that norepinephrine levels exhibited slow, rhythmic oscillations during non-REM sleep.</p>
<p>These oscillations coincided with synchronized cycles of blood vessel constriction and relaxation (vasomotion), which created a pumping mechanism to drive CSF through the brain. Importantly, these oscillations were absent during wakefulness and disrupted during REM sleep, suggesting that non-REM sleep provides a unique state for optimal glymphatic activity.</p>
<p>To confirm that norepinephrine oscillations were directly driving vasomotion, Hauglund and her colleagues used optogenetics to manipulate the locus coeruleus, a brain region responsible for norepinephrine release. By stimulating or inhibiting this region, they demonstrated that norepinephrine release tightly controlled blood vessel dynamics and, by extension, CSF flow.</p>
<p>To directly test whether vasomotion acts as a “pump” for CSF flow, the researchers conducted optogenetic experiments targeting smooth muscle cells in blood vessels. By using light to stimulate rhythmic constriction and relaxation of these vessels in naturally sleeping mice, they artificially increased the frequency of vasomotion.</p>
<p>The stimulation enhanced CSF flow and glymphatic clearance in brain regions near the site of vascular manipulation, providing direct evidence that cycles of arterial constriction and dilation drive glymphatic activity. This experiment confirmed that vasomotion plays a central role in the glymphatic system.</p>
<p>“We discovered that what drives the CSF flow through the brain, and thereby the brain cleaning during sleep, is a slow pumping mechanism created by synchronous constriction and dilation of the blood vessels in the brain,” Hauglund told PsyPost. “This is controlled by a signaling molecule called norepinephrine, which is released in the brain roughly every 50 seconds, creating slow oscillations in norepinephrine levels during sleep.”</p>
<p>Another experiment investigated how natural sleep microarchitecture, particularly the frequency of brief awakenings called micro-arousals, influenced glymphatic activity. Using EEG and EMG recordings to monitor brain activity and sleep states, the researchers correlated the frequency of micro-arousals with glymphatic clearance efficiency.</p>
<p>Mice with more frequent micro-arousals during non-REM sleep exhibited greater glymphatic clearance of tracer molecules. This finding supported the idea that norepinephrine oscillations and the associated vascular dynamics, which often coincide with micro-arousals, play a pivotal role in driving CSF flow.</p>
<p>Interestingly, while micro-arousals were associated with increased glymphatic activity, they were not the sole determinant of clearance. The researchers concluded that the oscillatory release of norepinephrine during non-REM sleep acts as the primary driver of CSF flow, with micro-arousals serving as a secondary, parallel process.</p>
<p>“Our study showed that the frequency of micro-arousals, tiny awakenings that happen throughout the night without being perceived by the sleeper, correlates positively with glymphatic flow,” Hauglund explained. “This may seem surprising, as micro-arousals are often viewed as a sign of fragmented sleep.”</p>
<p>“However, more and more evidence indicates that micro-arousals are a natural part of healthy sleep and may have important functions for the beneficial effects of sleep. The reason for the correlation between glymphatic flow and micro-arousals is that the norepinephrine waves that control the ‘pump’ driving the CSF flow also induce micro-arousals.”</p>
<p>To investigate the effects of zolpidem on sleep architecture and glymphatic activity, the researchers administered the drug to a group of mice and monitored norepinephrine levels, blood vessel dynamics, and CSF flow. Although zolpidem helped the mice fall asleep more quickly, it significantly disrupted the infraslow oscillations in norepinephrine levels and blood vessel vasomotion that are critical for glymphatic clearance.</p>
<p>Using EEG recordings, the researchers also observed that zolpidem-treated mice had more frequent micro-arousals but with diminished norepinephrine peaks. As a result, the natural synchronization of blood flow and CSF movement was impaired.</p>
<p>When the researchers measured glymphatic clearance by injecting a fluorescent tracer into the CSF, they found that zolpidem-treated mice exhibited reduced tracer inflow and clearance compared to control mice. This indicated that while zolpidem induced sleep, it interfered with the restorative processes of natural sleep, specifically the brain’s ability to clear harmful waste products through the glymphatic system.</p>
<p>“We found that the sleep aid zolpidem disrupted the norepinephrine oscillations and thereby reduced the fluid flow,” Hauglund told PsyPost. “This suggests that the sleep you get while using sleep medication is not as beneficial as regular sleep in terms of restorative processes, such as brain cleaning.”</p>
<p>The experiments were conducted in mice, which, while biologically similar in some respects, do not fully replicate human sleep architecture or physiology. However, Hauglund noted that “results from human studies indicate that the same mechanism exists. For example, MRI scans of people sleeping inside a scanner have shown that slow oscillations in blood volume and CSF volume are present in the brain during sleep.”</p>
<p>Future research could investigate how factors such as aging, vascular health, and neurodegenerative diseases impact the system’s efficiency. Exploring potential interventions to enhance glymphatic clearance—whether through pharmacological agents, lifestyle modifications, or non-invasive therapies—would also be valuable.</p>
<p>“Many questions are still waiting to be answered,” Hauglund said. “For example, is will be important to see how different disease states affect the CSF pumping, and if there are ways to enhance the ‘pump’ in order to boost the removal of waste from the brain.”</p>
<p>The study, “<a href="https://doi.org/10.1016/j.cell.2024.11.027" target="_blank" rel="noopener">Norepinephrine-mediated slow vasomotion drives glymphatic clearance during sleep</a>,” was authored by Natalie L. Hauglund, Mie Andersen, Klaudia Tokarska, Tessa Radovanovic, Celia Kjaerby, Frederikke L. Sørensen, Zuzanna Bojarowska, Verena Untiet, Sheyla B. Ballestero, Mie G. Kolmos, Pia Weikop, Hajime Hirase, and Maiken Nedergaard.</p></p>
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<td><a href="https://www.psypost.org/participants-report-improved-mental-health-and-personal-transformation-after-peyote-rituals/" style="font-family:Helvetica, sans-serif; letter-spacing:-1px;margin:0;padding:0 0 2px;font-weight: bold;font-size: 19px;line-height: 20px;color:#222;">Participants report improved mental health and personal transformation after peyote rituals</a>
<div style="font-family:Helvetica, sans-serif; text-align:left;color:#999;font-size:11px;font-weight:bold;line-height:15px;">Jan 25th 2025, 16:00</div>
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<p><p>An ethnographic study of individuals who participated in peyote ceremonies in rural north-central Alabama revealed four core areas of personal change attributed to these ceremonies: reduced drug and alcohol misuse, new perspectives on life, improved mental health, and enhanced physical health. Participants attributed these changes to an improved ability to endure challenges, brain rewiring, and a deeper connection with their spiritual selves. The findings were published in the <a href="https://journals.sagepub.com/doi/10.1177/00220426241274737"><em>Journal of Drug Issues</em></a>.</p>
<p>Peyote is a small, spineless cactus (<em>Lophophora williamsii</em>) native to parts of Mexico and the southwestern United States, renowned for its psychoactive properties. It contains mescaline, a naturally occurring hallucinogen that induces altered states of perception, mood, and consciousness.</p>
<p>Traditionally, peyote has been used by Indigenous peoples in spiritual ceremonies and healing practices due to its perceived ability to facilitate introspection and connection with the divine. Its use is restricted or regulated in many countries. In the United States, Native Americans are legally permitted to possess and ingest peyote as a religious sacrament. It has been a central element of the Native American Church since the early 20th century.</p>
<p>Study author Heith Copes and her colleagues sought to understand how individuals who use peyote in naturalistic settings perceive its impact on their lives. They aimed to explore how these individuals believe they have changed and what they attribute these changes to. The researchers believed that these insights could guide further investigation into the psychological effects, side effects, duration, and other characteristics of peyote.</p>
<p>The data were collected through a photo-ethnographic study of individuals who participated in peyote ceremonies in rural north-central Alabama. The study included formal interviews with 27 participants, informal observations during ceremonies, and photography. In total, the researchers conducted 46 interviews, as 14 individuals were interviewed more than once.</p>
<p>The researchers gained access to the group performing the peyote rituals through personal contacts with church leaders. After explaining their study goals and research plans, they were invited to attend the ceremonies.</p>
<p>The data collection process occurred in several stages. First, the researchers attended six ceremonies over a year and a half. They arrived a few hours before the ceremonies began to conduct ethnographic interviews, asking participants about their motivations for attending and their goals for the experience. The second data source consisted of semi-structured interviews conducted between ceremonies. Finally, photo-elicitation interviews were conducted with 16 of the 27 participants. This interviewing technique involves showing participants photographs to prompt responses and insights.</p>
<p>Of the 27 participants, 10 were women and 17 were men, ranging in age from 24 to 50 years old. One participant identified as White. All participants had prior experience using other psychedelics.</p>
<p>Overall, participants discussed four core areas of change they attributed to peyote use: reduced drug and alcohol misuse, new perspectives on life, improved mental health, and enhanced physical health. These changes were linked to an improved ability to endure challenges, brain rewiring, and a deeper connection with their spiritual selves.</p>
<p>“Nearly all participants found use of peyote in a ceremonial setting worthwhile, or at least potentially worthwhile. The most enduring outcome related to general mental health was an outlook that participants found refreshing and relieving. This outlook was often spiritual and philosophical and led to self-reflection. These lessons remained with participants although they were most salient in the short term,” the study authors concluded.</p>
<p>“Directly after taking peyote, between the next day and up to a few months, participants reported a sense that depression and anxiety symptoms were allayed and during this time, spiritual realizations were easily recalled and applied; participants reported doing positive mental and relationship work soon after ceremonies. An afterglow was typically reported as if it was a pharmacological form of relief, similar perhaps to antidepressants, but with far more robust effects.”</p>
<p>This study contributes to the scientific understanding of the personal experiences of participants in peyote ceremonies. However, it is important to note that this was an ethnographic study reporting solely subjective experiences as described by the participants.</p>
<p>The paper, “<a href="https://doi.org/10.1177/00220426241274737">Hitting the Reset Button: Ceremonial Use of Peyote and Experiences of Personal Change,</a>” was authored by Heith Copes, Andy Hochstetler, Jared Ragland, and Peter S. Hendricks.</p></p>
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<td><a href="https://www.psypost.org/loss-of-smell-linked-to-inflammation-across-139-distinct-medical-conditions/" style="font-family:Helvetica, sans-serif; letter-spacing:-1px;margin:0;padding:0 0 2px;font-weight: bold;font-size: 19px;line-height: 20px;color:#222;">Loss of smell linked to inflammation across 139 distinct medical conditions</a>
<div style="font-family:Helvetica, sans-serif; text-align:left;color:#999;font-size:11px;font-weight:bold;line-height:15px;">Jan 25th 2025, 14:00</div>
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<p><p>In a recent review published in <em><a href="https://www.frontiersin.org/journals/molecular-neuroscience/articles/10.3389/fnmol.2024.1455418/full" target="_blank" rel="noopener">Frontiers in Molecular Neuroscience</a></em>, researchers from UC Irvine and the University of Oxford have highlighted a profound connection between olfactory dysfunction—loss or impairment of the sense of smell—and inflammation across 139 distinct medical conditions. The research suggests that the sense of smell plays an underestimated but vital role in physical and mental health. Olfactory dysfunction may not merely be a symptom but could actively contribute to the onset and progression of diseases.</p>
<p>The researchers were motivated by the observation that olfactory dysfunction frequently accompanies a wide range of medical conditions, yet the reasons behind these associations remained unclear. The study’s lead author, UC Irvine’s Professor Emeritus Michael Leon, noted that he has long “been interested in the role that scents play in keeping the brain healthy.” Leon and his colleagues aimed to investigate whether olfactory loss could be more than a symptom, potentially serving as an early warning sign or even a contributing factor to the development of diseases.</p>
<p>To investigate, the team conducted an extensive review of existing literature, analyzing studies that documented olfactory dysfunction in conditions across three broad categories: neurological, somatic, and congenital or hereditary disorders.</p>
<p>“The loss of the ability to smell things is associated with at least 139 medical conditions, including heart disease, cancer, lung disease, liver disease and kidney disease – the diseases most likely to kill you,” Leon told PsyPost.</p>
<p>The review highlighted inflammation as a potential mechanism behind these associations. The olfactory system, due to its direct exposure to environmental pollutants and volatile substances, is particularly vulnerable to damage and inflammation. This damage can spread to other parts of the brain or body, exacerbating or triggering symptoms of various conditions.</p>
<p>For instance, inflammation in the olfactory bulb—the brain region responsible for processing smells—has been linked to cognitive decline and memory loss. Furthermore, the study showed that inflammation associated with olfactory loss could be aggravated by environmental factors such as air pollution, smoking, or stress.</p>
<p>“First, I was surprised by the sheer number of medical disorders associated with olfactory loss. Then, I was struck by the fact that all of them were also linked to chronic inflammation,” Leon said.</p>
<p>One of the most striking findings was the predictive power of olfactory loss. Studies cited in the research revealed that impaired smell ability could forecast cognitive decline, mortality, and the likelihood of developing specific diseases more accurately than traditional risk factors like cardiovascular health. For example, older adults with reduced olfactory function were shown to have a significantly higher risk of mortality over a 17-year period compared to those with normal smell ability.</p>
<p>The review also explored the potential for reversing or mitigating these effects through olfactory enrichment—exposure to pleasant scents that stimulate the olfactory system. <a href="https://www.psypost.org/pleasant-nighttime-scents-improve-memory-in-older-adults-new-research-shows/" target="_blank" rel="noopener">Previous research has shown</a> that olfactory enrichment can improve cognitive performance, reduce inflammation, and enhance memory in both healthy adults and individuals with dementia.</p>
<p>For instance, older adults exposed to daily scents such as lavender or eucalyptus experienced improvements in verbal fluency, attention, and memory recall. These findings suggest that olfactory stimulation could serve as a therapeutic intervention for preventing or slowing the progression of diseases linked to olfactory dysfunction.</p>
<p>Despite its groundbreaking contributions, the research is not without limitations. Much of the evidence comes from correlational studies, making it difficult to establish a direct causal link between olfactory dysfunction and specific medical conditions. Additionally, while inflammation appears to be a key factor, other mechanisms—such as direct neuroanatomical connections between the olfactory system and memory-related brain regions—may also play a role.</p>
<p>Future research should focus on longitudinal studies that track individuals over time to better understand these relationships. Experimental studies that manipulate inflammation levels or olfactory stimulation could further clarify causality.</p>
<p>“The memory centers of the brain need a great deal of olfactory stimulation to maintain their health,” Leon said. “We have developed a device called Memory Air that sits on your nightstand and delivers 40 scents twice a night as you are sleeping. This therapy has been shown to improve the memory of older adults, even those with dementia (Alzheimer’s disease). Nothing else comes close. Everyone probably needs more olfactory stimulation throughout their lives.”</p>
<p>The paper, “<a href="https://doi.org/10.3389/fnmol.2024.1455418" target="_blank" rel="noopener">Inflammation and olfactory loss are associated with at least 139 medical conditions</a>,” was authored by Michael Leon, Emily T. Troscianko, and Cynthia C. Woo.</p></p>
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<td><a href="https://www.psypost.org/maladaptive-daydreaming-may-mask-adhd-symptoms-delaying-diagnosis-until-adulthood/" style="font-family:Helvetica, sans-serif; letter-spacing:-1px;margin:0;padding:0 0 2px;font-weight: bold;font-size: 19px;line-height: 20px;color:#222;">Maladaptive daydreaming may mask ADHD symptoms, delaying diagnosis until adulthood</a>
<div style="font-family:Helvetica, sans-serif; text-align:left;color:#999;font-size:11px;font-weight:bold;line-height:15px;">Jan 25th 2025, 12:00</div>
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<p><p>A recent study published in the <a href="https://doi.org/10.1177/10870547241310990"><em>Journal of Attention Disorders</em></a> sheds light on a significant factor that could delay the diagnosis of attention deficit hyperactivity disorder in adults (ADHD): maladaptive daydreaming. Researchers found that individuals who experience excessive, compulsive fantasizing may unknowingly compensate for or mask their ADHD symptoms, leading to delays in diagnosis.</p>
<p>Maladaptive daydreaming <a href="https://www.psypost.org/maladaptive-daydreaming-the-compulsive-complex-fantasy-disorder-that-dominates-some-peoples-daily-lives/">is a behavioral phenomenon</a> characterized by excessive, immersive fantasizing that interferes with daily life. Unlike typical daydreaming, it is compulsive and can consume hours each day, often triggered by stress or negative emotions as a way to escape reality. While it may provide temporary emotional relief, it <a href="https://www.psypost.org/study-suggests-maladaptive-daydreaming-should-be-classified-as-a-unique-mental-disorder-distinct-from-adhd/">can lead to significant disruptions</a> in social, academic, and occupational functioning.</p>
<p>ADHD is one of the most common neurodevelopmental conditions, often diagnosed in childhood but persisting into adulthood for many individuals. ADHD is characterized by difficulties with attention, impulsivity, and hyperactivity, which can interfere with various aspects of daily life, including education, employment, and relationships.</p>
<p>As individuals age, the presentation of ADHD symptoms often changes. For example, hyperactivity may diminish, but attentional challenges and executive dysfunction frequently remain, continuing to disrupt an individual’s ability to organize, plan, and manage tasks. Despite its prevalence, ADHD remains underdiagnosed in adults, leaving many individuals without access to the treatment and support that could significantly improve their quality of life.</p>
<p>The delayed diagnosis of ADHD in adults is a growing concern in the field of mental health. The new study was conducted to explore possible factors contributing to delayed ADHD diagnoses in adults.</p>
<p>“As a clinician and researcher working with adults with ADHD, focusing on diagnostic challenges is inevitable,” said study author <a href="https://www.linkedin.com/in/alikandeger/">Ali Kandeğer</a>, an associate professor of psychiatry at Selçuk University and author of the <em>Information Booklet on Attention Deficit Hyperactivity Disorder for Youth and Adults</em> (<a href="https://drive.google.com/file/d/1s3q9mt8Uff3GglSyQKKEv-uI6AAYw_Ag/view">pdf</a>).</p>
<p>“When designing our studies, we aim to include thought structures (patterns) such as excessive mind wandering and maladaptive daydreaming. Adults are generally better able to describe the functional impairments caused by their thought structures, making these patterns particularly relevant for understanding diagnostic delays and their impact on daily life.”</p>
<p>The study analyzed data from 214 adults diagnosed with ADHD who were treated at the Adult Neurodevelopmental Disorders Clinic at Selçuk University in Türkiye between 2022 and 2024. Participants were divided into two groups: those diagnosed with ADHD during childhood or adolescence (before the age of 18) and those diagnosed in adulthood (18 years or older). The researchers collected detailed sociodemographic, clinical, and diagnostic data, alongside self-reported measures of ADHD symptoms, comorbidities, and maladaptive daydreaming.</p>
<p>Diagnostic evaluations followed the Structured Clinical Interview for DSM-5 Clinician Version, a comprehensive tool for diagnosing mental health conditions. The researchers also employed a range of validated self-report scales, including:</p>
<ul>
<li>The Adult ADHD Self-Report Scale to measure ADHD symptom severity.</li>
<li>The Maladaptive Daydreaming Scale to assess the frequency and severity of maladaptive daydreaming behaviors.</li>
<li>The Hospital Anxiety and Depression Scale and Childhood Trauma Questionnaire to evaluate comorbid conditions and past experiences of trauma.</li>
</ul>
<p>Participants completed these assessments over two sessions, with additional self-report data collected via online surveys. Individuals with incomplete forms or severe psychiatric conditions such as psychosis or bipolar disorder were excluded from the study to ensure accurate comparisons.</p>
<p>The researchers found several notable differences between adults diagnosed with ADHD in childhood versus adulthood. Adults diagnosed in adulthood tended to be older and had higher levels of education compared to those diagnosed earlier in life. They also exhibited more severe ADHD symptoms and higher levels of maladaptive daydreaming. Importantly, logistic regression analysis showed that maladaptive daydreaming severity was a significant predictor of receiving an ADHD diagnosis in adulthood, even when controlling for other factors such as age and education.</p>
<p>“When we set out on this study, our goal was to compare the sociodemographic and clinical characteristics of adults diagnosed with ADHD in childhood versus adulthood,” Kandeğer told PsyPost. “Utilizing a comprehensive data recording system, we sought to identify potential clues that might contribute to delayed diagnoses. Given the heterogeneous nature of ADHD, many symptoms and characteristics did not indicate delayed diagnosis.”</p>
<p>“However, what surprised us was that maladaptive daydreaming consistently emerged as a significant indicator of delayed diagnosis, even after controlling for confounding factors. This finding underscores maladaptive daydreaming’s unique role in masking ADHD symptoms and delaying help-seeking behavior.”</p>
<p>Further analyses revealed that in adults diagnosed in adulthood, maladaptive daydreaming was strongly correlated with the severity of ADHD symptoms, the number of comorbid psychiatric disorders, and symptoms of depression and anxiety. This pattern was not observed in individuals diagnosed during childhood or adolescence, suggesting that maladaptive daydreaming might play a unique role in delaying ADHD recognition among adults.</p>
<p>“The study highlights that maladaptive daydreaming can delay ADHD diagnoses until adulthood,” Kandeğer said. “Individuals who engage in excessive daydreaming often find temporary emotional relief but at the cost of functional impairments. Maladaptive daydreaming, by its nature, may mask ADHD symptoms due to reduced activity, decreased impulsivity, and less disruptive behavior during fantasy moments. This masking effect can lead to a delay in ADHD diagnosis until adulthood. Recognizing maladaptive daydreaming as a potential indicator could lead to earlier and more accurate diagnoses of ADHD in adults.”</p>
<p>But the study, like all research, includes some caveats.</p>
<p>“This study was cross-sectional and conducted in a single center, which limits generalizability,” Kandeğer noted. “We relied on self-report measures, which can introduce bias. Additionally, the relatively young age range of our sample (mean age of 23 years) might not reflect older adults with ADHD. Future longitudinal research is needed to confirm these findings.”</p>
<p>“My future goals are to adapt unique thought and behavioral patterns, such as MD, to scientific methodology while investigating novel findings related to the diagnosis and treatment of ADHD in adulthood. Additionally, I am particularly interested in exploring whether MD influences objective neurocognitive tests, which is the next question we aim to address.”</p>
<p>The study, “<a href="https://doi.org/10.1177/10870547241310990">Could Maladaptive Daydreaming Delay ADHD Diagnosis Until Adulthood? Clinical Characteristics of Adults With ADHD Based on Diagnosis Age</a>,” was authored by Ali Kandeğer, Hasan Ali Güler, Münise Seda Özaltın, Ömer Bayırlı, Hacer Söylemez, Elif Yıldız, and Bengi Semerci.</p></p>
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<td><a href="https://www.psypost.org/neurofeedback-offers-minimal-improvements-for-adhd-symptoms/" style="font-family:Helvetica, sans-serif; letter-spacing:-1px;margin:0;padding:0 0 2px;font-weight: bold;font-size: 19px;line-height: 20px;color:#222;">Neurofeedback offers minimal improvements for ADHD symptoms</a>
<div style="font-family:Helvetica, sans-serif; text-align:left;color:#999;font-size:11px;font-weight:bold;line-height:15px;">Jan 25th 2025, 10:00</div>
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<p><p>A systematic review and meta-analysis published in <em>JAMA Psychiatry</em> has found no evidence that neurofeedback meaningfully improves ADHD symptoms at the group level. However, small but statistically significant effects emerged when standard neurofeedback protocols targeted processing speed, a neuropsychological measure. Despite these limited findings, neurofeedback appears to offer minimal benefit for clinical or cognitive symptoms of ADHD overall.</p>
<p>ADHD is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity, which can significantly impair daily functioning. While medications, particularly stimulants, are effective in reducing symptoms, not all individuals respond to or tolerate pharmacological treatments. Nonpharmacological interventions like neurofeedback have been proposed as alternatives. Neurofeedback is a technique that uses a brain-computer interface to train individuals to regulate their brain activity in real time, often through electroencephalogram (EEG) feedback. Proponents argue that by learning to normalize ADHD-related brain patterns, individuals can alleviate their symptoms and improve cognitive performance.</p>
<p>Although neurofeedback has been studied for decades, its clinical efficacy remains controversial. Many past studies were limited by small sample sizes, inadequate blinding, or suboptimal protocols. Recent advances, including the use of standardized neurofeedback methods and neuroimaging technologies, provided an opportunity to reassess its potential. The new meta-analysis sought to determine whether neurofeedback offers meaningful benefits for ADHD symptoms and related cognitive impairments when evaluated through rigorous, blinded research.</p>
<p>“Neurofeedback has been proposed as a treatment for ADHD and its widely used. It has a lot of advocates. However, the evidence as to effectiveness was mixed,” said study author <a href="https://scholar.google.com/citations?user=GkXN_CcAAAAJ&hl=en" target="_blank" rel="noopener">Edmund J.S. Sonuga-Barke</a>, a professor of developmental psychology, psychiatry, and neuroscience at King’s College London.</p>
<p>A meta-analysis is a research method that combines the results of multiple studies on a particular topic to draw a more comprehensive conclusion. By statistically analyzing data from different studies, a meta-analysis identifies patterns, evaluates the overall effectiveness of an intervention, and provides a more precise estimate of outcomes than individual studies alone.</p>
<p>In the current study, the meta-analysis included 38 randomized clinical trials published up to July 2023. These trials included 2,472 children, adolescents, and adults diagnosed with ADHD. Participants underwent neurofeedback interventions that primarily targeted EEG activity, with a smaller subset involving newer techniques such as functional magnetic resonance imaging (fMRI) or near-infrared spectroscopy (fNIRS).</p>
<p>The meta-analysis focused on outcomes measured after participants completed neurofeedback training. ADHD symptoms were assessed using reports from individuals close to the intervention setting (e.g., parents, teachers) and probably blinded sources, such as independent clinicians.</p>
<p>“Probably blinded” refers to situations in research where the person reporting or assessing outcomes is likely unaware of which treatment or intervention participants received, but complete certainty about their blinding cannot be guaranteed. Probably blinded contrasts with fully blinded (where blinding is explicitly confirmed) and unblinded (where the assessor clearly knows the treatment).</p>
<p>The researchers also examined neuropsychological outcomes, including measures of attention, working memory, and processing speed. Sensitivity analyses explored whether results differed when standard neurofeedback protocols were used or when evidence of learning to regulate brain activity was demonstrated.</p>
<p>The results showed that neurofeedback did not significantly improve core ADHD symptoms, such as inattention or hyperactivity, when evaluated using probably blinded reports. This finding held true across nearly all sensitivity analyses. Small but statistically significant effects were observed in studies that adhered to well-established standard neurofeedback protocols. Specifically, these protocols appeared to produce reductions in total ADHD symptom severity, but the effects were not large enough to be clinically meaningful.</p>
<p>“Concerning the substantial number of well designed trials, where raters are blinded to intervention allocation – there was no evidence that the use of neurofeedback led to clinically meaningful reductions in ADHD symptoms at the level of the whole group,” Sonuga-Barke told PsyPost. “There was also almost no impact on neuropsychological processes, which might be considered a more proximal target for treatment.”</p>
<p>Neurofeedback only showed promising results in one specific area: processing speed. Participants in neurofeedback trials demonstrated small but significant improvements in this cognitive domain, suggesting that the intervention may enhance certain aspects of neuropsychological functioning. Importantly, these gains in processing speed were also observed at longer-term follow-up assessments, indicating some durability of the effects. However, neurofeedback did not lead to significant improvements in other cognitive outcomes, such as attention or working memory.</p>
<p>When compared to other treatments, neurofeedback was less effective than stimulant medication in reducing ADHD symptoms, based on outcomes reported by individuals close to the intervention. Additionally, neurofeedback did not perform better than other nonpharmacological interventions, such as cognitive training or physical exercise.</p>
<p>“This finding was in line with our previous work so we were not especially surprised, but rather disappointed that recent trials of neurofeedback have not shown better outcomes,” Sonuga-Barke said. “We desperately need effective non-pharma treatments.”</p>
<p>The study, “<a href="https://doi.org/10.1001/jamapsychiatry.2024.3702" target="_blank" rel="noopener">Neurofeedback for Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis</a>,” was conducted by Samuel J. Westwood, Pascal-M. Aggensteiner, Anna Kaiser, Peter Nagy, Federica Donno, Dóra Merkl, Carla Balia, Allison Goujon, Elisa Bousquet, Agata Maria Capodiferro, Laura Derks, Diane Purper-Ouakil, Sara Carucci, Martin Holtmann, Daniel Brandeis, Samuele Cortese, and Edmund J. S. Sonuga-Barke, on behalf of the European ADHD Guidelines Group (EAGG).</p></p>
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<p><strong>Forwarded by:<br />
Michael Reeder LCPC<br />
Baltimore, MD</strong></p>
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