Why Friendships are Important for Boys' Health

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Why Friendships Are Important for Boys’ Health

A recent study suggests that boys who spend more time with friends grow into healthier adults.

This article was written by MARYAM ABDULLAH and published on September 18, 2018, found in Greater Good Magazine.

For my three-year-old son, his playmates are an endless source of entertainment: They meet up at the park to go down the slide, ride tricycles, and conspire in plenty of shenanigans. As he gets older, I hope he will also experience the unparalleled gift of great friendship, with all the delight, reassurance, interconnection, and opportunities for growth that it brings.  

My hopes are echoed in a new study published in Psychological Science, which found that boys’ friendships are not just fun and rewarding—they could also lead to better health.

Jenny Cundiff and Karen Matthews explored whether boyhood friendships were related to physical health in adulthood. The study enrolled over 250 six-year-old boys attending public schools in an urban city in the United States in the late 1980s. The boys were primarily black (56 percent) and white (41 percent), and mostly came from families receiving public financial assistance (61 percent). 

The researchers followed up with the boys twice a year for the first four years and then annually for nine years. Each year, parents answered the following question about their children: “Over the past year, how much time has your son spent with his friends during an average week?” The researchers recontacted the men when they were in their early 30s and assessed their physical health, by measuring their blood pressure and body mass index.  

The researchers found that men who had spent more time with their friends as children tended to have lower blood pressure and body mass index 20 years later. What’s more, this link was not explained by the men’s level of social interaction as adults or their childhood health problems, body mass index, socioeconomic status, hostility, or extraversion.  

Why does childhood friendship coincide with better adult health? It didn’t seem to be due to something else in the boys’ lives that made them both connected and healthy, like participating more in sports or having more involved parents. But a few other studies provide some promising, direct explanations. 

For example, a research review by Megan Gunnar and Camelia Hostinar argues that social support could play an important role in kids’ stress physiology. Having friends who can support you in times of adversity and help you find ways to cope could buffer against the harmful effects of stress in the body. 

In particular, it’s possible that friends protect against bullying. Although parents have a primary role in helping young kids cope with stress, friends begin to take on this important role in later childhood, particularly during early experiences with bullying. Another study by Kristin Kendrick and colleagues found that kids who have at least one good friend, whom they count on to be a source of emotional and practical support, are less likely to be involved in bullying—either as a perpetrator or victim—one year later.

How to help boys maintain friendships 

We may have a tendency to downplay the role of friendships in boys’ lives compared to girls’, but that would be a mistake. In a recent research review, Amanda Rose and Steven Asher address the “damaging stereotypes that males are inept at relationships.” Indeed, a 2010 research review by Francois Poulin and Alessandra Chan explains that boys’ friendships are at least as stable or more compared to girls’ friendships. Here are three tips parents can use to help their kids with friendships.

1. Reassure kids that even good friends sometimes make mistakes.

 Rose and Asher highlight that children who are successful at making and keeping friends are good at coping with a friend who has fallen short of expectations—for example, a buddy who took a joke too far and didn’t realize that he hurt them.

Encouraging your child to stick with a friend who has disappointed them can be tricky. Friendships are voluntary, and it’s easy to walk away from a relationship if you feel wronged. If your child is inclined to shut down, leave the situation fuming, and discard the friendship forever, then practice active listening as he or she shares the experience with you.  

Did active listening reveal any positive, redemptive qualities of the friend that you could revisit with your child? If yes, then together explore ways that your child can communicate assertively about the lapse in kindness and give the friend a chance to respond and make amends.  

Of course, discussing the severity and frequency of friendship transgressions will also help kids set expectations and limits for their peers so that they have healthy relationships.  

2. Encourage kids to be OK with a friend having other friends, too. 

According to Rose and Asher, children who are successful at navigating friendships may be more likely to appreciate that it is possible to have many friends; they embrace their friends’ independent choices without being possessive or expecting exclusivity. 

In a recent study, Hwaheun Kim and colleagues write, “Jealousy over friends is common at the start of early adolescence but begins declining very quickly for some children as adolescence progresses and they better recognize that the outside interests of their friends do not necessarily imply negative things about their own relationship.”  

The ability to deal with strong emotions seems to play a role in this kind of jealousy. In their study of 10- to 15-year-old, mostly white adolescents in the southern United States, the researchers found that adolescents with lower self-esteem also tended to be more jealous, but only if they had a difficult time coping with strong emotions. 

So how can we help adolescents process difficult emotions? In their 2010 study, Kristin Neff and Pittman McGehee suggest that teaching adolescents self-compassion may promote their resilience and support them in intense emotional experiences. During a self-compassion break, adolescents can acknowledge the challenge they are contending with, recognize that everyone struggles sometimes, and offer self-kindness.

3. Take the temperature of your own adult friendships. 

Children’s friendships may take after their parents’ friendships, according to a 2013 study of over 170 fifth-, eighth-, and eleventh-graders living in the Midwest. Gary Glick and colleagues found that kids with greater friendship issues such as antagonism, disagreements, and quarrels were more likely to have moms with higher-conflict adult friendships.  

Although the study could not confirm that one caused the other, Glick and colleagues suggest that moms who have a lot of conflict with their friends may signal to their kids that this is normal when it comes to friendships.  

Modeling how to handle disagreements in adult relationships may be a way to help kids problem-solve with their friends. Parents could set an example by trying to step back and take a broader perspective on an argument rather than refusing to see the other person’s point of view. Friends could also try walking together, a conflict resolution tactic that helps two people get on the same page through parallel movement and attention. Finally, acts of self-affirmation such as reflecting on your personal values and identity have been shown to lessen defensiveness during conflict and foster trust, compromise, and closeness.

Apart from my son having fun pals on the playground, my wish is for him to have the depth of friendship highlighted by E.B. White in Charlotte’s Web: “You have been my friend. That in itself is a tremendous thing.” Friendship will strengthen his heart in more ways than one, it seems.


Maryam Abdullah, Ph.D., is the Parenting Program Director of the Greater Good Science Center. She is a developmental psychologist with expertise in parent-child relationships and children’s development of prosocial behaviors.

DOES YOUR CHILD HAVE PLENTY OF TIME TO PLAY?

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DOES YOUR CHILD HAVE PLENTY OF TIME TO PLAY? JUST. PLAY?

[The original article was written on August 8, 2015 by Jacqueline on her website.]

 

There is a lack and serious need for wholesome play in childhood.

On August 1, 1966, the day Dr. Stuart Brown started his assistant professorship at the Baylor College of Medicine in Houston, 25-year-old Charles Whitman climbed to the top of the University of Texas Tower on the Austin campus and shot 46 people.

 

Whitman, an engineering student and a former U.S. Marine sharpshooter, was the last person anyone expected to go on a killing spree. 

After Brown was assigned as the state’s consulting psychiatrist to investigate the incident and later, when he interviewed 26 convicted Texas murderers for a small pilot study, he discovered that most of the killers, including Whitman, shared two things in common: they were from abusive families, and they didn’t play as kids.

Brown did not know which factor was more important. But in the 42 years since, he has interviewed some 6,000 people about their childhoods, and his data suggest that a lack of opportunities for unstructured, imaginative play can keep children from growing into happy, well-adjusted adults. 

“Free play,” as scientists call it, is critical for becoming socially adept, coping with stress, and building cognitive skills such as problem-solving.  (source)

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SKEPTICAL ABOUT THE VALUE OF PLAY?

It’s terribly sad the old-fashioned notion of summer as endless free time – to climb trees, pick blackberries, chase fireflies, build a fort, or make popsicles – is just a distant memory for most. It’s what children need – they need it far more than they need a high-priced summer camp, dance lessons, or some program aimed at cramming a little bit more learning into their exhausted brains.

For play skeptics, experiments conducted by the Early Childhood Cognition Lab in the Department of Brain and Cognitive Sciences at the Massachusetts Institute of Technology (MIT) show children calculating probabilities during play, developing assumptions about their physical environment, and adjusting perceptions according to the direction of authority figures. Other researchers are also discovering a breathtaking depth to play: how it develops chronological awareness and its link to language development and self-control.

I keep reading the statistics about how kids are spending less time playing, NO recess in schools, and about how they are spending more time seated at a desk or in a car or doing homework after being in school all day. Over the last three decades, children have lost 8 hours of free, unstructured, and spontaneous play a week.

Spending more time in front of the TV, with their electronic device, or over-scheduled with less time in wholesome play in side or out,is changing kids’ cognitive, creative, and emotional development. We know that children’s capacity for self-regulation—their ability to control their emotions and behavior and to resist impulses—is much worse than it was 60 years ago. In one study, today’s 5-year-olds had the self-regulation capability of a 3-year-old in the 1940s, and today’s 7-year-old barely approached the level of a 5-year-old 60 years ago.

 

Many parents suppose that creativity and the ability to control oneself is an inherited predisposition in a child – either they were born with or born without it. But actually, creativity and self-governance are learned skills rather than inborn traits or talents, and they are skills parents can help their kids develop through early years of play.

Simple, everyday things can make all the difference in a child’s development.

 

(a throwback to our earlier homeschool years…and yes, our children took some risks -some I knew about and some I didn’t!)

HUGE BENEFITS TO FREE PLAY

  • Ability to observe, problem solve, and understand connections = greater understanding
  • Learn acceptable ways to handle difficulty and challenges = greater measures of self control (competency)
  • Helps children learn how to work in groups, share, negotiate, resolve conflicts, regulate their emotions and behavior, and speak-up for themselves = greater self-governance (learning to say no to oneself) and less frustration
  • Develops productive citizens (builders, solid mates and parents, communicators, scientists, writers, artists, engineers, leaders) needed for a successful society

Neuroscientists, developmental biologists, and researchers from every point of the scientific compass now know that play is a profound biological process,” says Stuart Brown, a leading play researcher and author. “Play fosters empathy in kids, and lies at the very heart of creativity and innovation. And the ability to play has a profound effect on our outlook on life.”

1. READ-ALOUDS

Reading out-loud – sometimes a couple of hours a day – provides lots of food for children’s imagination, jump-starting play. Children are absorbent sponges and imitators, so make the content the BEST!

2. IMAGINATIVE PLAY AND DRESS-UP

From knights and cowboys to princesses and brides, children have been pretending practically forever. Dressing up in old clothes, hats, capes, and swords from Goodwill or Salvation Army offer them with lots of tools for acting out the stories that inspire their hearts. Parents should keep their eyes open but only interrupt if necessary to guide or redirect play. Children’s play will likely be innocent unless they have witnessed inappropriate things.

3. FEWER TOYS – ONES THAT DON’T DO MUCH ON THEIR OWN

 

Best: big (appliance-sized) cardboard boxes, blocks, a small wading pool (also used to clean after sandbox, dirt, mud puddles, painting), a sprinkler, balls, dolls, stuffed animals, puppets, a wagon, couch cushions, sheets, cardboard table for playhouse,  clothesline to make a tent with sheets, empty kitchen base cabinet (doubles as a ‘house’) that has a children’s cooking set and dishes near where you you cook, manipulatives and sensory binsEtch-A-Sketch, old costumes, props, scrap lumber (nails and hammer), a hatchet, scraps of fabric and a sewing machine, camera not tied to internet, journal, etc.

TOYS FOR FREE PLAY:

More toys for open-ended play worth owning.

4. GET OUTDOORS (IF AT ALL POSSIBLE)

Children (and adults) need time to listen to the wind whistle in the leaves, birds, a warm rain on their faces, or simply feel the warmth of the sun on their shoulders with a good book. Time to swing real high for the sheer joy of it and to explore God’s creation in all its grandeur. They’ll be surprised at what goes on in the world!

WHERE THE RUBBER MEETS THE ROAD

In Why Kids Need Unstructured Play, Madeline Levine makes a very strong case:

Kids who have no down time and no time for unstructured play never get to know themselves. They know only who others tell them they are. If they don’t have that they will be always looking for external direction and validation. Getting to know oneself takes time and emotional energy, and when all that is spent trying to get a leg up on an academic career, or become the best soccer player on the field, there is no time left for the internal work of whole-child development.

 

WHEN I GROW UP BY JIM DALY, ONE OF MY FAVORITE ARTISTS.

Learning who you are takes place not in the act of doing but in the quiet spaces between things. The more of these quiet spaces you can provide your children, the better.

Many young people today have never experienced the gift of a carefree early childhood and as parents one day (without turning to God for answers) will not be able to supply it to their own children. It only takes one, possibly two generations for the wonderful old ways of bringing up children to be lost.

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The Lost Art Of Roughhousing: Why Roughhousing Makes Kids Awesome

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Filed Under: A Featured Post Just for YouChildrenChildren's BooksHome EducationKid's HealthParentingShaping CultureVideo

What Happens to Kids When Parents Fight?

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What happens to kids when parents fight?

Conflict between parents is inevitable—but it doesn’t have to hurt kids. Here’s how to turn a disagreement into a positive lesson.

Children are like emotional Geiger counters

When I was a child, my parents’ fights could suck the oxygen out of a room. My mother verbally lashed my father, smashed jam jars, and made outlandish threats. Her outbursts froze me in my tracks. When my father fled to work, the garage, or the woods, I felt unprotected.

“Children are like emotional Geiger counters,” says E. Mark Cummings, psychologist at Notre Dame University, who, along with colleagues, has published hundreds of papers over twenty years on the subject. Kids pay close attention to their parents’ emotions for information about how safe they are in the family, Cummings says. When parents are destructive, the collateral damage to kids can last a lifetime.

My experience led me to approach marriage and parenthood with more than a little caution. As a developmental psychologist, I knew that marital quarreling was inevitable. According to family therapist Sheri Glucoft Wong, of Berkeley, California, just having children creates more conflicts, even for couples who were doing well before they became parents. “When kids show up, there’s less time to get more done,” she says. “All of a sudden you’re not as patient, not as flexible, and it feels like there’s more at stake.”

There must be a better way to handle conflict

But I also knew that there had to be a better way to handle conflict than the one I grew up with. When my husband and I decided to have children, I resolved never to fight in front of them. “Conflict is a normal part of everyday experience, so it’s not whether parents fight that is important,” says Cummings. “It’s how the conflict is expressed and resolved, and especially how it makes children feel, that has important consequences for children.”

Watching some kinds of conflicts can even be good for kids—when children see their parents resolve difficult problems, Cummings says, they can grow up better off.

What is destructive conflict?

In their book Marital Conflict and Children: An Emotional Security Perspective, Cummings and colleague Patrick Davies at the University of Rochester identify the kinds of destructive tactics that parents use with each other that harm children:

  • Verbal aggression like name-calling, insults, and threats of abandonment;
  • Physical aggression like hitting and pushing;
  • Silent tactics like avoidance, walking out, sulking, or withdrawing;
  • Capitulation—giving in that might look like a solution but isn’t a true one.

When parents repeatedly use hostile strategies with each other, some children can become distraught, worried, anxious, and hopeless. Others may react outwardly with anger, becoming aggressive and developing behavior problems at home and at school. Children can develop sleep disturbances and health problems like headaches and stomachaches, or they may get sick frequently. Their stress can interfere with their ability to pay attention, which creates learning and academic problems at school. Most children raised in environments of destructive conflict have problems forming healthy, balanced relationships with their peers. Even sibling relationships are adversely affected—they tend to go to extremes, becoming overinvolved and overprotective of each other, or distant and disengaged.

 Some research suggests that children as young as six months register their parents’ distress. Studies that follow children over a long period of time show that children who were insecure in kindergarten because of their parents’ conflicts were more likely to have adjustment problems in the seventh grade. A recent study showed that even 19-year-olds remained sensitive to parental conflict. Contrary to what one might hope, “Kids don’t get used to it,” says Cummings.

In a remarkable 20-year-old study of parental conflict and children’s stress, anthropologists Mark Flinn and Barry England analyzed samples of the stress hormone cortisol, taken from children in an entire village on the east coast of the island of Dominica in the Caribbean. Children who lived with parents who constantly quarreled had higher average cortisol levels than children who lived in more peaceful families. As a result, they frequently became tired and ill, they played less and slept poorly. Overall, children did not ever habituate, or “get used to,” the family stress. In contrast, when children experienced particularly calm or affectionate contact, their cortisol decreased.

More recent studies show that while some children’s cortisol spikes, other children’s cortisol remains abnormally low and blunted, and these different cortisol patterns seem to be associated with different kinds of behavioral problems in middle childhood. Other physiological regulatory systems can become damaged as well, such as the sympathetic and parasympathetic branches of the autonomic nervous system—these help us respond to a perceived threat but are also the “brakes” that rebalance and calm us.

In 2002, researchers Rena Repetti, Shelley Taylor, and Teresa Seeman at UCLA looked at 47 studies that linked children’s experiences in risky family environments to later issues in adulthood. They found that those who grew up in homes with high levels of conflict had more physical health problems, emotional problems, and social problems later in life compared to control groups. As adults, they were more likely to report vascular and immune problems, depression and emotional reactivity, substance dependency, loneliness, and problems with intimacy. 

Avoiding conflict is not a solution

Some parents, knowing how destructive conflict can be, may think that they can avoid affecting their children by giving in, or capitulating, in order to end an argument. But that’s not an effective tactic. “We did a study on that,” Cummings said. According to parents’ records of their fights at home and their children’s reactions, kids’ emotional responses to capitulation are “not positive.” Nonverbal anger and “stonewalling”—refusing to communicate or cooperate—are especially problematic.

“Our studies have shown that the long-term effects of parental withdrawal are actually more disturbing to kids’ adjustment [than open conflict],” says Cummings. Why? “Kids understand hostility,” he explains. “It tells them what’s going on and they can work with that. But when parents withdraw and become emotionally unavailable, kids don’t know what’s going on. They just know things are wrong. We’re seeing over time, that parental withdrawal is actually a worse trajectory for kids. And it’s harder on marital relationships too.”

Kids are sophisticated conflict analysts; the degree to which they detect emotion is much more refined than parents might guess. “When parents go behind closed doors and come out acting like they worked it out, the kids can detect that,” says Cummings. They’ll see you’re pretending. And pretending is actually worse in some ways. As a couple, you can’t resolve a fight you’re not acknowledging you’re having. Kids will know it, you’ll know it, but nothing will be made in terms of progress.”

On the other hand, he says, “When parents go behind closed doors and are not angry when they come out, the kids infer that things are worked out. Kids can tell the difference between a resolution that’s been forced versus one that’s resolved with positive emotion, and it matters.”

How to make conflict work

“Some types of conflicts are not disturbing to kids, and kids actually benefit from it,” says Cummings. When parents have mild to moderate conflict that involves support and compromise and positive emotions, children develop better social skills and self-esteem, enjoy increased emotional security, develop better relationships with parents, do better in school and have fewer psychological problems.

“When kids witness a fight and see the parents resolving it, they’re actually happier than they were before they saw it,” says Cummings. “It reassures kids that parents can work things through. We know this by the feelings they show, what they say, and their behavior—they run off and play. Constructive conflict is associated with better outcomes over time.” Children feel more emotionally secure, their internal resources are freed up for positive developmental growth, and their own pro-social behavior toward others is enhanced. In fact, many child behavior problems can be solved not by focusing on the child, or even the parent-child relationship, but simply by improving the quality of the parents’ relationship alone, which strengthens children’s emotional security.

Even if parents don’t completely resolve the problem but find a partial solution, kids will do fine. In fact, their distress seems to go down in proportion to their parents’ ability to resolve things constructively.  “Compromise is best, but we have a whole lot of studies that show that kids benefit from any progress toward resolution,” says Cummings.

Both Cummings and Glucoft Wong agree that children can actually benefit from conflict—if parents manage it well. “Parents should model real life…at its best,” says Glucoft Wong. “Let them overhear how people work things out and negotiate and compromise.” 

However, both also agree that some content is best kept private. Discussions about sex or other tender issues are more respectfully conducted without an audience. Glucoft Wong encourages parents to get the help they need to learn to communicate better—from parenting programs, from books, or from a therapist.

My own parents’ conflict no longer has the hold on me that it once did, thanks to careful work and a loving marriage of my own of thirty years. Our two daughters are now in their twenties and secure in their own loving partnerships, and I hope that the lessons of their childhood hold. When they were preschoolers and interrupted our disagreements with concern, my husband and I would smile and reassure them with our special code: I held my fingers an inch apart and reminded them that the fight was this big, but that the love was this big—and I held my arms wide open.

Conflict Tips

Courtesy of Sheri Glucoft Wong.

1. Lead with empathy:Open the dialog by first letting the other person know that you see them, you get them, and you can put yourself in their shoes.

2. Give your partner the benefit of the doubt: Assume the best intentions and help yourself remember that you love each other by adding an endearment.

3. Remember that you’re on the same team.Deal with issues by laying all the cards on the table and looking at them together to solve a dilemma rather than digging in on opposing sides. Then problem-solve with one another.

4. Constructive criticism only works when your partner can do something about what happened. If the deadline for soccer signup was already missed, remedy the current situation as best as possible and talk about how to do it better next time. Blaming won’t fix anything that’s already happened.

5. Anything that needs to be said can be said with kindness. Disapproval, disappointment, exasperation—all can be handled better with kindness.

______

This article written by Diana Divecha  is taken from an article in The Greater Good Science Center (January 26, 2016).

What is the Impact of Traumatic Stress on Brain Development?

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What is the impact of traumatic stress on brain development?

[This article was originally written for Psychology Today by Sarah-Nicole Bostan, M.A. ]

Traumatic stress impacts the developing brains of males and females differently, according to a new study from the Stanford University School of Medicine and the Early Life Stress and Pediatric Anxiety Program.

In youth with symptoms of post-traumatic stress, there is variation in the volume and surface area of the insula between males and females who have experienced traumatic stress versus those who have not, the study found. The insula is a region buried deep within the cerebral cortex that plays a key role in interoceptive processing (how much or how little attention one pays to sensory information within the body), emotion regulation, and self-awareness. The study was published online in the journal Depression and Anxiety on January 9. It is the first study to date which has examined sex differences in subdivisions of the insula in youth with trauma histories.

While many individuals experience trauma, curiously, not all of them develop post-traumatic stress disorder (PTSD). People who are diagnosed with PTSD or have had a traumatic stressor in their lives endure exposure to actual or threatened death and “intrusive” thoughts afterward, which are associated with the traumatic event. These intrusive symptoms are coined such because they are unwanted and unwelcome by the individual who experiences them, and can include repeated, involuntary distressing memoriesdreams, flashbacks, and intense, prolonged psychological and physiological reactions, as if the traumatic event were still occurring (even though it has long ceased). In turn, the individual exposed to trauma who is prone to developing PTSD will avoid any stimuli associated with the traumatic event and will experience changes in thought and mood, as well as consistently heightened arousal (APA, 2013). Previous neuroscience research has found that changes in the insula following trauma contribute not only to the development of PTSD, but also to its maintenance. Similarly, it was found that women who experience trauma are more likely to develop PTSD (Hanson et al., 2008), but scientists have not been able to pinpoint why... until now.

59 youth between the ages of 9 and 17 participated in the study. Half of the individuals exhibited PTSD symptoms and half did not. The two trauma versus no-trauma groups had similar age, IQ, and sex characteristics. Of the 30 participants (14 female and 16 male) with trauma, 5 reported one traumatic stressor, while the remainder (n=25) reported more than two traumatic stressors or chronic trauma exposure. Using structural magnetic resonance imaging (sMRI), researchers scanned the participants’ brains and compared healthy male and female brains to the brains of males and females with PTSD symptoms. Though there were no structural differences in insula subdivisions between healthy male and female brains, there were notable differences between males and females in the traumatized group. Boys with trauma had larger insula volume and surface area than boys in the control group, while girls with trauma had smaller insula volume and surface area than girls in the control group. This finding suggests that trauma not only impacts the developing brain, but also that it impacts the development of boys and girls quite differently.

Insula volume decreases with aging (Shaw et al., 2008), and the reduced insula volumes in girls with PTSD symptoms suggests that this part of the brain is prematurely aging in part due to traumatic stress. Klabunde, Weems, Raman, & Carrion (2017) drove home the importance of these findings in their paper:

“By better understanding sex differences in a region of the brain involved in emotion processing, clinicians and scientists may be able to develop sex-specific trauma and emotion dysregulation treatments.” 

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The study also helps highlight the interplay between nature and nurture when it comes to assessing complex mental health issues, such as PTSD. While most people do not readily have access to equipment such as an MRI scanner used to elucidate this study’s findings, mental health professionals and patients alike do have the ability to remember that environmental stress translates to neurobiological changes and that these changes differ between the sexes, meaning a one-size-fits-all approach to PTSD will be much less effective than a treatment which considers contextual variables of the individual, such as biological sex. 


The article citation is listed below and can also be found at this link.

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. 5th Edition. Arlington, VA: American Psychiatric Publishing. 

Hanson, R. F., Borntrager, C., Self-Brown, S., Kilpatrick, D. G., Saunders, B. E., Resnick, H. S., Amstadter, A. (2008). Relations among Gender, Violence Exposure, and Mental Health: The National Survey of Adolescents. The American Journal of Orthopsychiatry, 78(3). Pp. 313 - 321. 

Klabunde, M., Weems, C. F., Raman, M., & Carrion, V. (2017). The moderating effects of sex on insula subdivision structure in youth with posttraumatic stress symptoms. Depression and Anxiety 34. Pp. 51 - 58. 

Shaw, P., Kabani, N. J., Lerch, J. P., Eckstrand, K., Lenroot, R., Gogtay, N., Greenstein, D., Clasen, L, Evans, A., Rapoport, J. L., Giedd, J. N., Wise, S. P. (2008). Neurodevelopmental Trajectories of the Human Cerebral Cortex. Journal of Neuroscience, 28(14). Pp. 3586 - 3594.