Mindfulness-Based Stress Reduction Program

I mentioned research-supported findings about how stress affects physical health and well being in my last post “Worried about my telemers.” Since then, I have attended and completed an anxiety study at the Massachusetts General Hospital, and I’ve learned a few interesting things. It was an interesting experience as well.

The study (about which I learned from an ad on the subway) is titled “Stress Reduction Techniques and Anxiety: Therapeutic and Neuroendocrine Effects,” and it is sponsored by the National Institute of Health, and is conducted by the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital. I believe they are still accepting “subjects.” As the Center’s website says, the study is “testing the effectiveness of two types of stress management courses for the treatment of Generalized Anxiety Disorder at the Center for Anxiety and Traumatic Stress Disorders.”

I was in the “meditation” class, and our teacher came from the University of Massachusetts Medical School Center for Mindfulness in Medicine, Health Care, and Society. Apparently, studies show that Mindfulness-Based Stress Reduction offers “reductions in medical and psychological symptoms across a wide range of medical diagnoses,” as UMass Medical Center’s page on research boasts, so now the MGH study is comparing the effects of MBSR to another stress management course.

Because we were “lab rats” so to speak, we did not have to pay tuition for the class, which normally is around $500 at the UMass Medical Center, although the center’s page does say: “Our goal is to the make the Stress Reduction Program available to those who can benefit without regard to ability to pay. Alternative payment options may be considered.”

Incidentally, my health insurance company, Harvard Pilgrim, offers a 15% discount off a mindfulness class at UMass Medical, but I also found that it offers a six-week class for only $150, which is a much better deal. Too bad Harvard Pilgrim offers it in only one location. Harvard Pilgrim’s site also has a page about mindfulness, together with free MP3 meditation downloads.

During the first class I asked our meditation teacher about the difference between the MBSR program and the programs at MGH’s Benson-Henry Institute for Mind Body Medicine. She said that there is an important difference, but I never got to hear what it is, because we were interrupted. I got to hear Dr. Benson speak once about his program, and it sounded fascinating. By the way, the Benson-Henry Institute is the only place in Massachusetts I found that offers a six-week stress management class specifically for parents of “behaviorally challenging children.”

Worried about my telemers

I had never heard about telemers until I watched “Stress: Portrait of a killer” on DVD.

Sure, I knew before that stress is not good for my physical health, after reading Minding the Body, Mending the Mind, by Joan Borysenko, but I had no idea that stress in a way damages our DNA (if I understand the process correctly). Yet that’s what Elizabeth Blackburn and Elissa Epel, two guest scientists on the show, were claiming.

Fascinated by their research, I looked for more information and what I found first freaked me out completely.

Apparently, chronic stress experienced by parents who have children with special needs or disabilities is very dangerous as it “may promote earlier onset of age-related diseases.” (Elissa S. Epel, Elizabeth H. Blackburn, Jue Lin, Firdaus S. Dhabhar, Nancy E. Adler, Jason D. Morrow, Richard M. Cawthon (2004) Proceedings of the National Academy of Sciences of the United States of America, Vol. 101, No. 49 (Dec. 7, 2004), pp. 17312-17315.)

But when I dug some more, there seems to be a glimmer of hope –further research seems to suggest that “comprehensive lifestyle changes” which include “moderate aerobic exercise […]; stress management[…], and a 1-h group support session once per week” were “significantly associated with increases in cellular telomerase activity and telomere maintenance capacity in human immune system cells.” (Dean Ornish, Jue Lin, Jennifer Daubenmier, Gerdi Weidner, Elissa Epel, Colleen Kemp, Mark Jesus M Magbanua, Ruth Marlin, Loren Yglecias,Peter R Carroll, Elizabeth H Blackburn (2008) Lancet Oncol 2008; 9: 1048–57.)

If I get it right then, I’m on a fast lane to developing age-related diseases, unless I exercise, meditate, and create a good support network for myself. I better get cracking!

Connection between levels of fetal testosterone and autistic traits

I wanted to title this post “Would you want to know if your child might be autistic?” but after reading in the Guardian Prof. Simon Baron-Cohen’s response article titled “Our research was not about prenatal screening for autism,” I have decided to give my post a different, more neutral title, and closer to the title of the original research article.

I am talking here about a discussion in the Guardian spurred by Professor Simon Baron-Cohen’s research published in the February 2009 issue of the British Journal of Psychology, titled “Fetal testosterone and autistic traits.”

On January 12, 2009, the Guardian published a front-page article “New research brings autism screening closer to reality,”by Sarah Boseley (health editor), which was accompanied by a double-page spread inside the paper titled “Disorder linked to high levels of testosterone in womb”  (also by Sarah Boseley).

The articles resulted in several comments. The same day, January 12, 2009, Michael Fitzpatrick published “Toxic treatments for autistic children” with a sub-headline “Worrying about antenatal testing is premature — there are dangerous procedures being performed on children now.”

Then on January 14, Anya Ustaszewski published “I don’t want to be ‘cured’ of autism, thanks” and Marcel Berlins published “Newton and Einstein may have been autistic. But is their genius an argument against a screening test?“(which generated 113 comments by the time the comments were closed).

Finally, on January 20, 2009, the Guardian published a response from Simon Baron-Cohen I mentioned above — “Our research was not about prenatal screening for autism,” with a sub-headline “We merely aimed to understand what causes differences in autistic traits” in which he slams the January 12, 2009 articles’ headlines and captions as “inaccurate.”

Baron-Cohen explains

The new research was not about autism screening; the new research has not discovered that a high level of testosterone in prenatal tests is an indicator of autism; autism spectrum disorder has not been linked to high levels of testosterone in the womb; and tests (of autism) in the womb do not allow termination of pregnancies.
The Guardian was reporting on our new study in the British Journal of Psychology that found a correlation between levels of foetal testosterone (FT) and the number of autistic traits a child shows at the age of eight. The study was not about prenatal screening for autism, and indeed did not even test children with autism.

Interestingly, before Sarah Boseley’s articles appeared in the Guardian, on January 7, 2009 the paper published “A prenatal test for autism would deprive the world of future geniuses,” by James Randerson, referring to Simon Baron-Cohen’s article on the BBC web site”Autism test ‘could hit maths skills’” in which he says

Research is not yet at the stage where autism can be detected prenatally using a biological test [...] But assuming such a test is developed, we would be wise to think ahead as to how such a test would be used.

I must say that while I find Baron-Cohen’s research fascinating, and liked his Guardian article and like the tone of this article overall as well, I have a huge problem with a statement

If reducing the testosterone in a foetus helped that baby’s future social development, we would all be delighted.

Frankly, I for one would not be delighted if people started meddling with babies’ “future social development” by manipulating fetal testosterone levels or in any other way. I don’t think we should be getting into the business of controlling future generations’ personalities. Do you think we should?

(Added January 28, 2009 — I found a blog, alisonleary.com, (which seems to have closed since then) with an entry on the same subject — “Testosterone Levels Linked to Autistic Traits,” which provides a link to the Autism Research Centre at Cambridge University, which in turn provides a link to the original, 22-page, article “Fetal testosterone and autistic traits” published in the British Journal of Psychology.)

Engineers, Hips, and Autism

The headline “Men who don’t find curvy women attractive ‘could father children with autism‘” sounds just too weird to pass up. I found it through Google alert on a rather curious blog “What Sorts of People.”

The entry does not comment on the title, just refers people to an article in the Daily Mail Reporter, published on January 8, 2009, with the same title as the blog entry.

A different blog, Feminist Philosophers, also mentioning the article, quotes

“Studies show that the waist-to-hip ratio of 70 per cent is what the majority of men find most attractive because it correlates strongly with good health and fertility”

and questions the “because.”

Knowing how the media have the tendency to distort the conclusions of scientific studies to make them more sensational (see, for example, the entry “Parental psychiatric disorders and children with autism“ from May 9, 2008), I went first to the actual press release, which is titled “Who we find attractive could have implications for the prevalence of autism, say researchers.”

I must say I agree with the Feminist Philosophers poster’s surprise at making an assumption that who we find attractive is strictly correlated to who we actually marry (or with whom we have children), which is what the authors of the study seem to imply. (Otherwise, they should have gone straight for assessing “the actual dimensions of parents of children with autism.”)

But I wanted more, so I found the actual article, published in the Journal of Autism and Developmental Disorders (J Autism Dev Disord) published by Springer.

The article, written by Drs Mark Brosnan and Ian Walker, both from the Department of Psychology at the University of Bath, is titled “A Preliminary Investigation into the Potential Role of Waist Hip Ratio (WHR) Preference within the Assortative Mating Hypothesis of Autistic Spectrum Disorders,” and was published in the January 2009 issue of the journal.

It is dense and somewhat tough to understand to a not-even-close-to-being-a-psychology-dr like me, but once I read it a couple of times I actually found it fascinating, because of a few points the authors raise that are not mentioned either in the Daily Mail article, or in the press release.

If I understand it correctly (and I must say I’m not sure I do), the whole point starts with assuming that there is a connection between testosterone levels in mothers and the fact that

“ASD affects somewhere between four and nine times as many males as females.”


“ASD’s male predominance has led to suggestions that autistic traits might be influenced by prenatal androgens, as prenatal testosterone exposure has been found to correlate with abilities associated with the triad of impairments.”

Here the article refers to three scientific articles examining androgens, fetal testosterone levels, and autistic traits.

(I had to look up what “androgens” means. Apparently androgens “stimulate or control the development and maintenance of masculine characteristics,” and the “most well-known androgen is testosterone.”)

So what I think the article says is that high or higher than typical levels of testosterone in a woman’s body while she’s pregnant might be one of the factors that could cause autism.

The second point is that

“testosterone levels in women are visibly signaled by waist-to-hip ratio (WHR: waist circumference divided by hip circumference) because testosterone causes the accumulation of fat cells around the waist.” (The typical range apparently is around 0.7-0.8.)

The hypothesis is then framed as follows

“[I]f some men were found to show a preference for higher-than-average-WHR mates, this would encourage greater prenatal testosterone exposure for these men’s offspring. Critically, if this preference were seen more than average in men with a genetic predisposition towards having children with ASD, this would make the incidence of ASD higher in a population than we would otherwise expect. Their genetic predisposition to ASD could potentially interact with the maternal genetic predisposition (passed from mother to child).”

Now, no matter how you look at it, to me statements like “a man attracted to higher-than-average waist-to-hip ratio women is likely to have a higher-than-average prenatal testosterone exposure for their offspring” do assume that the man in question will actually have “offspring” with that “higher-than-average WHR ratio” woman that he’s attracted to. I don’t think that’s necessarily true, but let’s say it is.

So what I think the researchers are saying is that just because you are a “boxy” (higher than average WHR) woman does not mean you will have a child with autism. But if you have children with a man who has a “broader autistic phenotype,” then the chance that your child with have autism is higher than average.

And now comes the interesting part, not mentioned in the Daily Mail or the press release – the “broader autistic phenotype” is apparently tied (if not equal) to a man’s “higher systemizing skills.”

Drs Brosnan and Walker refer to studies from a couple of years ago showing that

“fathers of children with ASD have been found to be overly represented within Science/Engineering disciplines”

and that there is an

“evidence associating children with autisms’ familiar over-representation in highly systemizing activities (such as engineering or mathematics).”

In plain words – the way I understand it – autism spectrum seems to run in families of engineers and other mathematically oriented professions.

(The article does not mention computer programmers or coders but I bet they are part of the group as well. I actually would expand it to include most academics overall; I’ve been working with academics for nearly fifteen years, I’ve seen some interesting “phenotypes” quite worthy of extended studies.)

That reminds me of the comment my son’s neuropsychologist made when I responded “it’s not the end of the world” when she confirmed the diagnosis of PDD-NOS – She said “Of course not! Just go and take a walk around the MIT campus!” (see the “Yes, it is PDD-NOS after all!” entry on May 2, 2008)

Laughing out loud, the Massachusetts Institute of Technology is probably one of the best places in the world to find a guy with “highly systemizing skills.” By the way, I went once to a ballroom dance class at MIT – it’s heaven for girls, they get to dance all the time, and it’s the guys who have to wait for a turn! (And no, it’s not where I met my husband, but he is good at systemizing. And no, I will not publicize my WHR.)

So again, a “boxy” woman will not necessarily have a child with autism just because she’s less curvy, and a scientist will not necessarily have a child with autism because he’s good at math, but if the two have children, then the chance that their first born male child will have autism is greater than average, especially if the guy was not a first-born himself.

(Oh, yeah – here are a couple more interesting nuggets not mentioned in the press release or the article – Apparently “engineers have relatively more sons than daughters.” Also, “the risk of ASD is higher in first-borns.” And there also seems to be a pattern “of children with ASD being firstborns to fathers who were not firstborn themselves.”)

What about “boxy” women who are scientists marrying their fellow scientist colleagues? I’m sure someone will study that soon (if they haven’t already).

And what I’d like to know is whether all women in the photographs used in the study, those with average WHR and those with higher than average, were equally well endowed in the “bosom department.” Yeah, I know guys look at the “WHR” but I think those measurements also play a big role (otherwise there wouldn’t be such a big market for implants). Although naturally big err.. cup size, probably has something to do with testosterone and estrogen levels as well, so in the end it probably doesn’t matter.

Food dyes and the Center for Science in the Public Interest

This isn’t exactly news – I found this information months ago, when the press release just came out, but I had no time to blog during the summer, so here it is:

An organization calling itself the Center for Science in the Public Interest (CSPI) petitioned the U.S. Food and Drug Administration to ban artificial colorings from food. The press release page has links to the petition itself, and also mentions Dr. Ben Feingold with a link to his Feingold Association of the United States, and two British studies exploring the effects of artificial food colorings on children’s behavior.

The first study was published in 2004, in Archives of Disease in Childhood – “The effects of a double blind, placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children,” by B Bateman, J O Warner, E Hutchinson, T Dean, P Rowlandson, C Gant, J Grundy, C Fitzgerald, J Stevenson.

The second study was published in 2007 in The Lancet – “Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomized, double-blinded, placebo-controlled trial,” by Dona McCann, Angelina Barrett, Alison Cooper, Debbie Crumpler, Lindy Dalen, Kate Grimshaw, Elizabeth Kitchin, Kris Lok, Lucy Porteous, Emily Prince, Edmund Sonuga-Barke, John O Warner, Jim Stevenson.

The CSPI is also “urging parents who believe their children are harmed by food dyes to file reports online at http://www.cspinet.org/fooddyes/.”

Biomedical Treatments for Autism

Saturday, November 1, and Sunday, November 2, 2008 there will be a conference in Weston, Massachusetts titled “Successful Inclusion in School & Community” organized by Autism Conferences of America.

It looks interesting and I would like to see “Learning Social Skills Through Play: Life’s Most Important Skill Made Fun!” by Rick Clemens, MA, and would love to see “Biomedical Treatments for Autism from A to Zinc” by Nancy O’Hara, MD. Unfortunately $95 to listen to two lecture is a bit steep for me, so I’ll have to pass.

However, the conference web site also includes a pdf of an article titled “Summary of Biomedical Treatments for Autism” written by James B. Adams, Ph.D., which sounds very interesting. James B. Adams is Full Professor in the Department of Chemical and Materials Engineering at Arizona State University, and Director of the Autism/Asperger’s Research Program.

The Autism/Asperger’s Research Program site includes a pdf of another publication – “Pilot Study of a Moderate Dose Multivitamin/Mineral Supplement for Children with Autistic Spectrum Disorder,” by James B. Adams, Ph.D. and Charles Holloway, B.S. published in The Journal of Alternative and Complementary Medicine in 2004.

By the way, The Journal of Alternative and Complementary Medicine is the official journal of the International Society for Complementary Medicine Research and the Society for Acupuncture Research. It is a peer-reviewed journal, it has an editorial board, and the publisher’s web page on Manuscript Submission says “A primary goal of this international peer-reviewed journal is the establishment of rigorous and appropriate research methodologies.” The Editor-in-Chief is Kim A. Jobst, MA, DM, MRCP, MFHom, DipAc, and a Visiting Professor in Healthcare & Integrated Medicine at Oxford Brookes University. 

Now, the developmental pediatrician that tracks my son says the studies so far do not prove whether it’s the nutritional deficiencies that cause autism or it’s the autism that causes nutritional deficiencies. But she did give us a referral to see a nutritionist.

In the meantime, I wonder whether I should ditch the regular vitamins for two months and try to enroll our son in the National Vitamin/Mineral Study for Children & Adults with Autism at the ASU’s Autism/Asperger’s Research Program to see what happens. Of course, there’s the risk that he’d be on the placebo and we personally would not benefit from this study.