Almost every morning on NPR there is talk of a recession.  Are we headed for a recession?  What will happen if there is a recession?  Are the markets going to fall even further?  What are people thinking about the economic stimulus packages that the government is proposing to avoid a recession?

In a recent talk about her work on risky families,  Shelley Taylor mentioned offhand that this work makes her think about recession in a new way– financial stress can place a major burden on families, which may lead to less supportive environments for children.  Is a pending recession a risk factor for depression and other health problems when children born today grow up?

One of the major findings of Taylor’s work is that the early childhood environment really matters.  The question is no longer about nature versus nurture, but rather about the interaction between an individual’s genes and his or her environment.  For example, in the case of the serotonin transporter gene, having two copies of the short allele, in combination with a negative early family environment, confers increased risk for depression and other problems.  In the context of a rich and nurturant early family environment, however, individuals with the short-short combination may actually do the best.  Researchers have conceptualized this in terms of “sensitivity to the social environment” (individuas with the short-short combo are highly sensitive to the social environment, whereas individuals with long-short or long-long may be less sensitive to the social environment and do pretty well either way).  Another good example is the MAOA gene– individuals who are low in MAOA, and who grow up in abusive contexts tend to have much higher probability of showing aggressive behavior (including violent arrests) than individuals who have high levels of MAOA or who grow up in supportive environments (see: Caspi, McClay, Moffitt, Taylor, & Craig: Role of genotype in the cycle of violence in maltreated Children.  Science. 2002).

Back to the question of a recession and its potential impact on children being born now, we don’t have data supporting or refuting this claim, but I have been thinking about the types of markers that might be able to address this type of question.  There is tons of evidence that socioeconomic status plays a major role in health, morbidity and mortality, but what does this mean for people when their financial position changes?   Will a recession now lead to more depression and health problems 20 years down the line?  Will the threat and stress of a potential recession have similar effects?

I have recently read a bunch of articles about placebo effects and pain. In the case of pain, placebo effects can be remarkable. In fact, pain-sensitive brain regions are less active when people receive pain and a placebo, compared to the equivalent pain without a placebo. Furthermore, in anticipating pain with a placebo, pre-frontal control regions are more active, which may serve to regulate the experience of pain and/ or to trigger the body’s own anti-pain medication (opioids).

Interestingly, placebo effects can be both positive (as in you feel better after taking a non-active pill, receiving an irrelevant intervention), or negative (you feel side effects from taking the pill, just as with regular meds). Also, placebo effects are often dose-response, and can have time-effect curves, and carryover effects, just like active medications.

This brings me to the topic of mind body interaction. Many people in my department study these types of effects, and certainly don’t think of them as placebo. So, where is the line between placebo and mind-body treatments? Is it just the way we label them?

As a really cool example of mind-body interaction, check out Mike Irwin’s study (press release) of immune response to the virus that causes shingles. In this study, older adults who did tai chi (meditation through movement), had higher levels of immune functioning and quality of life scores than people in a wait-list control group. Interestingly, the effects of the tai chi intervention were additive with the shingles vaccine, such that older adults who received both the tai chi intervention and the vaccine had cell-mediated immune levels comparable to those of younger adults (who are at much lower risk for getting shingles as a result).

Some other articles about pain and placebo:

Turner et al. (1994): The Importance of placebo effects in pain treatment and research.

Hrobjartsson & Gotzsche (2001): Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment.

Stewart-Williams (2004): The placebo puzzle: Putting together the pieces.

Some other articles about Mind-Body stuff:

Cruess, D. G., Antoni, M. H., McGregor, B. A., Kilbourn, K. M., Boyers, A.E., Alferi, S.M., Carver, C. S., & Kumar, M. (2000). Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding about women being treated for early stage breast cancer. Psychosomatic Medicine, 62(3), 304-308. (4 pages)

Davidson, R.J., Kabat-Zinn, J., Schumacher, J. Rosenkranz, M., Muller, D., Santorelli, S.F., Urganowski, R., Harrington, A., Bonus, K. & Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564-570. (6 pages)

Storch, M., Gaab, J., Kuttel, Y., Stussi, A, & Fend, H. (2007). Psychoneuroendocrine effects of resource-activating stress management training. Health Psychology, 26(4), 456-463. (7 pages)