Thursday, October 28, 2010


Bullying in America: Time to Confront National Crisis Experts Say

Caroline Cassels

October 27, 2010 — The shocking rash of 4 recent suicides involving young, allegedly gay, males where bullying was cited as a major factor in their deaths has refocused attention on what experts say is a national public health crisis that must be confronted.

The New York Times reports 15-year-old Billy Lucas hanged himself September 9 after reportedly being told by students at his high school to commit suicide. Asher Brown and Seth Welsh, both 13 years old, also took their lives in September after being bullied for being gay.
Vigil for Tyler Clementi. Reena Rose Sibayan/AP

In the same month Rutgers University freshman Tyler Clementi jumped from the George Washington Bridge after 2 of his fellow students allegedly videotaped a sexual encounter of Clementi and another man then posted it online.

A recent national survey, also released in September, and conducted by the Gay, Lesbian, and Straight Education Network (GLSEN), shows 90% of lesbian, gay, bisexual, and transgender (LGBT) youth experience harassment at school.

"It is so clear that anti-LGBT actions and behaviors and language are really the weapon of choice in a lot of American schools," Joseph Kosciw, PhD, GLSEN senior director of research and strategic initiatives, told Medscape Medical News.

Jack Drescher, MD, a distinguished fellow of the American Psychiatric Association (APA) and a past chair of the APA's committee on GLB issues, says based on his clinical experience working with LGBT patients, he is not surprised by the GLSEN findings.

One perennial idea that needs to be challenged is that being bullied toughens kids we have seen in the reports of recent months, in some cases children do not toughen up but break down.

"I have treated many gay patients who, as adults, tell of stories of being publicly bullied and harassed, not only by other kids but by family members. The kids who are most at risk are those who are unable to hide gender atypical behavior — they are considered either too effeminate as boys or too masculine as girls," Dr. Drescher told Medscape Medical News.

"Not only do they experience verbal harassment, threats of violence, and actual violence, the way these kids are treated serves as a warning to other kids who may be LGBT but not so easily spotted," Dr. Drescher added.

Dr. Drescher went on to note that while much has been done in recent years to get schools and parents to take greater control of environments that permit bullying, more needs to be done.

"One perennial idea that needs to be challenged, for example, is that being bullied toughens kids up. However, this often serves as a pretext or rationalization for not exerting adult control over the antisocial behavior of some children. And as we have seen in the reports of recent months, in some cases children do not toughen up but break down," he said.

The Problem Persists

It is so clear that anti-LGBT actions and behaviors and language are really the weapon of choice in a lot of American schools.

Dr. Kosciw noted that although there is a growing awareness of the damaging effects of LGBT bullying, and bullying in general, the problem persists.

"We have been monitoring the experience of school students — LGBT as well as students in the general population — for the past 10 years, and sadly we haven't seen enormous changes in school climates for LGBT students.

"There has been some reduction in homophobic remarks and some changes since 2007 in victimization, but when you look at the whole picture there haven't been too many increases in school safety, particularly for this population, and there's much more work to be done," he said.

The survey also revealed that 61.1% of LGBT students felt unsafe in school because of their sexual orientation and 39.9% felt unsafe because of their gender expression.

National statistics show that in the United States approximately 30% of youth engage in bullying either as victims or perpetrators or both.

At the University of Houston, researcher Allison Dempsey, PhD, assistant professor, educational psychology, agreed and said that although subgroups such as LGBT youth have higher victimization rates, in the general population estimates of bullying among middle and high school students are also unacceptably high and run at about 30%.

"National statistics show in the United States approximately 30% of youth engage in bullying either as victims or perpetrators or both," she told Medscape Medical News. In fact, she added, the United States has a higher rate of youth bullying than many countries.

International rates of student victimization range from a low of 4.1% in Sweden to a staggering 41% in Lithuania, said Dr. Dempsey.


What constitutes bullying? "There is overt bullying which includes physical assaults, such as kicking and punching, as well as verbal assaults, such as name-calling.

"Then there is relational bullying, which can involve excluding people, spreading rumors about them, so essentially attacking their social status, and more recently we've seen the emergence of cyberbullying, where children are harassed via the Internet," said Dr. Dempsey.

Although cyberbullying accounts for about 10% of youth victimization, Dr. Dempsey added, it has the potential to be even more pernicious than "traditional" bullying settings.

"The most disturbing aspect of cyberbullying is that kids can't get away from it by leaving the school grounds or leaving the social situation. Nowadays kids have their phones with them almost all the time and have their computers in their bedrooms, so no matter where they are the bullies can get to them," she said.

"Cyberbullying is also a less noticeable form of bullying, so there is even less opportunity for bystanders to intervene. We know that only 1 in 10 kids that are bullied online actually tell somebody about it," she added.

Weighing in on this issue, APA President Carol Bernstein, MD, agreed there is an "ease" to cyberbullying that is unsettling. "The anonymity of it and the fact that you can taunt someone without having to face them is disturbing. It makes bullying easier," she said.

On the other hand, said Dr. Dempsey, it is worth noting that youth who use the Internet to victimize others are often unaware that they are leaving an "electronic trail" that can be used by the victim to prove bullying occurred and in potential legal proceedings.

"We are hearing a lot about cyberbullying, and while it is important, it only accounts for about 10% of [bullying] incidents. We definitely need to pay attention to it, but we should not neglect the issue of bullying in traditional settings because these account for the majority [of incidents]," she added.

The Damage

There's no doubt, say the experts, that bullying can have serious negative consequences — in the short term and over time.

Bullying has been associated with increased school dropout rates, as well as higher rates of depression, social anxiety, suicidal ideation, aggression, and academic problems.

However, Dr. Dempsey noted, that longitudinal research also suggests that beyond an association, there is a causal effect, and victims can experience serious, long-term negative outcomes.

A study...showed young children who are severely or continually bullied have a 4-fold increased risk of developing psychotic symptoms in early adolescence.

A study published in May 2009 in Archives of General Psychiatry and reported by Medscape Medical News at that time showed young children who are severely or continually bullied have a 4-fold increased risk of developing psychotic symptoms in early adolescence.

Dr. Dempsey noted that recent work by her group, which is currently under review, shows a positive correlation between bullying and suicidal ideation and suicide attempts over time.

In addition to LGBT youth, there are other subgroups of young people who experience higher than average rates of victimization, including those with psychiatric and chronic medical conditions.

According to Dr. Dempsey, up to one-third of children with diabetes experience "disease-related" bullying, which can have a negative impact on their physical, as well as psychological, health.

"If kids are called 'junkies' for taking insulin shots, they may reduce the amount of insulin they inject. We also know that kids with asthma experience increased rates of victimization," she said.

In May, research published in the journal Pediatrics and also reported by Medscape Medical News showed obese and overweight children had up to a 2-fold increased risk of being bullied than their peers who were not obese.

"Kids who are overweight and obese are more often bullied, causing increased stress, which then leads to binge eating and ultimately increases their weight," said Dr. Dempsey.

Antibullying Legislation

So how can youth bullying be curbed if not eliminated? GLSEN's research shows schools with so-called Gay-Straight Alliances, clubs that offer an opportunity to address issues relevant to LGBT students, result in a more positive school experience.

Dr. Kosciw added that the presence of supportive staff and firm antibullying policies in schools contribute to more positive outcomes for all kids. This is a key priority for GLSEN, which, among other initiatives, recently relaunched its Safe Space Kit designed to help educators create a safe space for LGBT youth in schools.

If passed, federal antibullying legislation would require schools and districts that receive federal funding to adopt anti-bullying policies and codes of conduct.

GLSEN research also shows students who live in states with enumerated antibullying legislation —that is, laws that specifically list factors such as sexual orientation, gender identity, race, and religion — report more positive school climates and experiences compared with their counterparts who live in states without such laws.

At the national level, Dr. Kosciw notes that, GLSEN is a staunch supporter of the Safe Schools Improvement Act, which was introduced in the US Senate earlier this year.

If passed, this federal antibullying legislation would require schools and districts that receive federal funding to adopt antibullying policies and codes of conduct that prohibit bullying or harassment on the basis of race, color, religion, national origin, sex, disability, sexual orientation, and perceived or gender identity.

Warning Signs

At the individual level, Dr. Dempsey said, it is important that educators, parents, and clinicians screen for bullying and directly ask children and youth about the issue.

It is also important that family physicians, pediatricians, and psychiatrists, who may have patients with chronic physical or mental illnesses, be aware that these patients are at increased risk for victimization and screen for it.

She noted that children who are bullied often experience changes in behavior, such as aggression, loss of appetite, insomnia, or a reluctance to go to school, among others, and that these should be treated as warning signs that bullying may be occurring.

"We need to educate people to look for this and understand all the different behaviors that are parts of bullying. It is not just hitting or punching, but it is also spreading rumors about somebody or trying to cause embarrassment to that person, and so people need to recognize and take it very seriously when they see it happening," said Dr. Dempsey.

"I personally wonder that if there's something about the culture [in the United States] that makes bullying more acceptable than in other countries. There are a lot of people out there that have the attitude that bullying is a part of growing up, and until we shift those attitudes we're not going to see change," she added.

Alice Demo Dancing Under the Gallows H264 No TCB

Thursday, October 21, 2010


The Ultimate Irony
By Jim Kirwan

What would you do if you knew there was an unrecognized addictive disease, global in nature that was infecting almost every prominent 'leader' in this nation and probably the world?

We do not allow known Drug Addicts or Alcoholics to hold political office, just as we do not allow rapists or murders into positions of power or control: Which is why we outlawed these behaviors-but we not only allow the Mentally-Addicted to Money & Power into higher office; it's practically a basic qualification.

The mentally-addicted are definitely in the majority among the insiders in all circles of real power; locally, nationally and globally. Yet this disease can and does routinely infect anyone of either gender, or of any race or religion: These are those that are mentally-addicted to the acquisition of money & power, to the exclusion of all else (in the same way Drug Addicts are addicted to their drugs ­ they're just mental-druggies of a slightly different type) and yet it has never been recognized as the mental-disease that has ruined so much of society, and is currently destroying the stability of the entire planet!

Why has psychiatry not bothered to examine, much less identify, this mental-disease in the same way as they have gone to so much trouble to identify all sorts of other prosecutable physical and mental diseases, many of which they cannot even medically prove? Could it be that this is a mental-disease, a phobia really, which this nation wants to foster and protect; almost like a sacrament, or some kind of sacred and very desirable passion?

After all as many believe: "The Business of America is Business" ­ right? And if it's true that money and power are both the root and the goal of most businesses; then does it not stand to reason that the devaluation of money and power to the status of an Addiction should not only be possible, but should have standing as a violation of civil and criminal codes. And would this not begin to give us a way to remove these creatures that have lost all humanity in their quest for their drug-of-choice ­ which can only be obtained through their mental-addiction to money & power?

Perhaps this doesn't matter in the grand scheme of political control; considering that nearly everyone today "who counts" is already a mental-addict to money & power (which is probably why this global-pandemic was never identified by those that want to criminalize all of our other addictions)-for their personal and private profit of course. What do you think and how would this affect the current-prison population in the USA today?

Ironic isn't it!

Monday, October 18, 2010



Wednesday, Sep. 22, 2010
How the First Nine Months Shape the Rest of Your Life
By Annie Murphy Paul

What makes us the way we are? Why are some people predisposed to be anxious, overweight or asthmatic? How is it that some of us are prone to heart attacks, diabetes or high blood pressure?

There's a list of conventional answers to these questions. We are the way we are because it's in our genes: the DNA we inherited at conception. We turn out the way we do because of our childhood experiences: how we were treated and what we took in, especially during those crucial first three years. Or our health and well-being stem from the lifestyle choices we make as adults: what kind of diet we consume, how much exercise we get.(See 5 pregnancy myths debunked.)

But there's another powerful source of influence you may not have considered: your life as a fetus. The kind and quantity of nutrition you received in the womb; the pollutants, drugs and infections you were exposed to during gestation; your mother's health, stress level and state of mind while she was pregnant with you — all these factors shaped you as a baby and a child and continue to affect you to this day.

This is the provocative contention of a field known as fetal origins, whose pioneers assert that the nine months of gestation constitute the most consequential period of our lives, permanently influencing the wiring of the brain and the functioning of organs such as the heart, liver and pancreas. The conditions we encounter in utero, they claim, shape our susceptibility to disease, our appetite and metabolism, our intelligence and temperament. In the literature on the subject, which has exploded over the past 10 years, you can find references to the fetal origins of cancer, cardiovascular disease, allergies, asthma, hypertension, diabetes, obesity, mental illness — even of conditions associated with old age like arthritis, osteoporosis and cognitive decline.

The notion of prenatal influence may conjure up frivolous attempts to enrich the fetus: playing Mozart to a pregnant belly and the like. In reality, the shaping and molding that goes on in utero is far more visceral and consequential than that. Much of what a pregnant woman encounters in her daily life — the air she breathes, the food and drink she consumes, the chemicals she's exposed to, even the emotions she feels — is shared in some fashion with her fetus. The fetus incorporates these offerings into its own body, makes them part of its flesh and blood.

Often it does something more: it treats these maternal contributions as information, biological postcards from the world outside. What a fetus is absorbing in utero is not Mozart's Magic Flute but the answers to questions much more critical to its survival: Will it be born into a world of abundance or scarcity? Will it be safe and protected, or will it face constant dangers and threats? Will it live a long, fruitful life or a short, harried one?

Research on fetal origins — also called the developmental origins of health and disease — is prompting a revolutionary shift in thinking about where human qualities come from and when they begin to develop. It's turning pregnancy into a scientific frontier: the National Institutes of Health embarked last year on a multidecade study that will examine its subjects before they're born. It's also altering the perspective of thinkers outside of biology. The Nobel Prize — winning economist Amartya Sen, for example, co-authored a paper about the importance of fetal origins to a population's health and productivity: poor prenatal experience, he writes, "sows the seeds of ailments that afflict adults." And it makes the womb a promising target for prevention, raising hopes of conquering public-health scourges like obesity and heart disease through interventions before birth. (See why drinking during pregnancy is now o.k.)

The Origins of Fetal Origins

Two decades ago, a British physician named David Barker noticed an odd correlation on a map: the poorest regions of England and Wales were the ones with the highest rates of heart disease. Why would this be, he wondered, when heart disease was supposed to be a condition of affluence — of sedentary lifestyles and rich food? He decided to investigate, and after comparing the adult health of some 15,000 individuals with their birth weight, he discovered an unexpected link between small birth size — often an indication of poor prenatal nutrition — and heart disease in middle age. Faced with an inadequate food supply, Barker conjectured, the fetus diverts nutrients to its most important organ, the brain, while skimping on other parts of its body — a debt that comes due decades later in the form of a weakened heart.

When he presented his findings to colleagues, he was greeted with hoots and jeers. "Heart disease was supposed to be all about genetics or adult lifestyle factors," says Barker, now 72 and a professor at the University of Southampton in England and at Oregon Health and Science University. "People scoffed at the idea that it could have anything to do with intrauterine experience." Barker persisted, however, amassing evidence of the connection between birth weight and heart disease in many thousands of individuals. For years the idea was known as the Barker hypothesis.

See how to prevent illness at any age.

In time his idea began to win converts. Janet Rich-Edwards, an epidemiologist at Brigham and Women's Hospital in Boston, deliberately set out to disprove the Barker hypothesis. "I was convinced that your current risk factors determine your odds of developing disease," says Rich-Edwards, "not something that happened when you were a fetus." But, she adds, "there's nothing like your own data to change your mind." Rich-Edwards analyzed findings from the Nurses' Health Study, a long-running investigation of more than 120,000 RNs. Even when she took account of the nurses' adult lifestyles and socioeconomic status, the relationship between low birth weight and cardiovascular-disease risk remained robust. "Similar studies have been conducted at least two dozen times since then," she notes. "It's one of the most solidly replicated findings in the field of public health."

As a journalist who covers science, I was intrigued when I first heard about fetal origins. But two years ago, when I began to delve more deeply into the field, I had a more personal motivation: I was newly pregnant. If it was true that my actions over the next nine months would affect my offspring for the rest of his life, I needed to know more. (See why smoking during pregnancy may lead to uncoordinated kids.)

Of course, no woman who is pregnant today can escape hearing the message that what she does affects her fetus. She hears it at doctor's appointments, sees it in the morning newspaper and in the pregnancy guidebooks: Do eat this, don't drink that, always be vigilant — but never stressed. Expectant mothers could be forgiven for feeling that pregnancy is nothing but a nine-month slog, full of guilt and devoid of pleasure, and this research threatened to add to the burden.

But as I began applying what I learned to my own pregnancy, I developed a very different perspective on fetal origins. The scientists I met weren't full of dire warnings but of the excitement of discovery — and the hope that their discoveries would make a positive difference. We're used to hearing about all the things that can go wrong during pregnancy, but as these researchers are finding out, it's frequently the intrauterine environment that makes things go right in later life.

The Power to Change Behavior

Take, for example, the prospect of maintaining a healthy weight. Americans are heavier than ever, and their weight gain begins ever earlier in life. Could it be that a tendency for obesity is being programmed in the womb? A pair of studies conducted by researchers at Harvard Medical School suggest that may be the case: the greater a woman's weight gain during pregnancy, one study found, the higher the risk that her child would be overweight by age 3. The second study indicated that this relationship persists into the offspring's adolescence. Compared with the teenagers of women who had moderate weight gain during pregnancy, those of women who had excessive weight gain were more likely to be obese.

Of course, children could share eating habits or a genetic predisposition to obesity with their mothers; how can we know the prenatal environment is to blame? Researchers have compared children born to obese mothers with their siblings born after the mothers have had successful antiobesity surgery. The later-born children inherited similar genes as their older siblings, and (research shows) practice similar eating habits, but they experienced different intrauterine environments. In a 2006 study published in the journal Pediatrics, researchers found that the children gestated by women postsurgery were 52% less likely to be obese than siblings born to the same mother when she was still heavy. A second study by the same group, published in 2009, found that children born after their mothers lost weight had lower birth weights and were three times less likely to become severely obese than their older brothers and sisters. (See if your pregnancy will predict postpartum depression.)

"The bodies of the children who were conceived after their mothers had weight-loss surgery process fats and carbohydrates in a healthier way than do the bodies of their brothers and sisters who were conceived at a time when their mothers were still overweight," says John Kral, a professor of surgery and medicine at SUNY Downstate Medical Center in New York and a co-author of both papers. Their metabolisms were, in effect, made normal by their prenatal experience — perhaps through a process known as epigenetic modification, in which environmental influences affect the behavior of genes without altering DNA. It may be that the intrauterine environment is even more important than genes or shared eating habits in passing on a propensity for obesity, Kral says. If that's so, helping women maintain a healthy weight before and during pregnancy may be the best hope for stopping obesity before it starts.

The science of fetal origins also offers hope to people who believe that heredity has doomed their families to disease — people like the Pima Indians of the Gila River Reservation in Arizona, who have the highest rate of Type 2 diabetes in the world. There is little doubt that the high incidence of diabetes among the Pimas, and among Native Americans in general, has a significant genetic component. But new research from a study that has followed a large group of Pima Indians since 1965 points to an additional influence: prenatal experience. During pregnancy, a diabetic woman's high blood sugar appears to disrupt the developing metabolism of the fetus, predisposing it to diabetes and obesity.

See the top 10 medical breakthroughs of 2009.

Exposure to maternal diabetes in utero accounts for most of the increase in Type 2 diabetes among Pima children over the past 30 years, says Dana Dabelea, associate professor of epidemiology at the University of Colorado at Denver and an investigator on the study, and it may well be a factor in the alarming rise of the disease nationally. But it also opens a door to intervention. "If we could intensively control diabetic women's blood sugar during pregnancy," Dabelea says, "we could really bring down the number of children who go on to develop diabetes."

What's more, an understanding of the role of gestational factors in disease can change individual behavior, notes Daniel Benyshek, a medical anthropologist at the University of Nevada at Las Vegas, who has interviewed members of Arizona's Native American tribes. He finds that those who believe diabetes is their genetic destiny tend to hold fatalistic attitudes about the illness. When Benyshek shared findings about the fetal origins of diabetes with tribe members, however, he noticed a different reaction. "The idea that some simple changes made during pregnancy could reduce the offspring's risk for diabetes fosters a much more hopeful and engaged response," he says. "Young women in particular are enthusiastic about the idea of intervening in pregnancy to break the cycle of diabetes. They say, 'I tried dieting, I tried exercising, and I couldn't keep it up. But I could do it for nine months if it meant that my baby would have a better chance at a healthy life.'" (See when it's o.k. to get pregnant after a miscarriage.)

The Impact of Air
The chance of a healthier life is what Frederica Perera is trying to give children in some of New York City's struggling neighborhoods. Perera, the director of the Center for Children's Environmental Health at Columbia University, became interested in the effects of pollution on fetuses more than 30 years ago, when she was conducting research on environmental exposures and cancer in adults. "I was looking for control subjects to compare to the adults in my study, individuals who would be completely untouched by pollution," she says. She hit on the idea of using babies just out of the womb as her controls, but when she received the results from samples of umbilical-cord blood and placental tissue she'd sent to a laboratory to be analyzed, she was sure there had been a mistake. "I was shocked," she says. "These samples I thought would be pristine already had evidence of contamination."

Since then, research by Perera and others has tied exposure to traffic-related air pollution during pregnancy to a host of adverse birth outcomes, including premature delivery, low birth weight and heart malformations. One of Perera's most striking studies got under way in 1998, when more than 500 pregnant women fanned out across upper Manhattan and the South Bronx wearing identical black backpacks, which they wore every waking moment for two days. Inside each backpack was an air monitor continuously measuring levels of polycyclic aromatic hydrocarbons, or PAHs, a type of pollutant that comes from vehicle exhaust and is also present in the fumes released by cigarettes and factory smokestacks.

The monitors revealed that 100% of the women were exposed to PAHs during their pregnancies. After their babies were born, analyses of cord blood from the infants showed that 40% had subtle DNA damage from PAHs — damage that has been linked to increased cancer risk. Further analysis found that those exposed prenatally to high levels of PAHs were more than twice as likely to be cognitively delayed at age 3, scoring lower on an assessment that predicts performance in school; at age 5, these children scored lower on IQ tests than children who received less exposure to PAHs in the womb.

Investigations like these have prompted scientists to expand their list of populations that are especially vulnerable to pollution. "We used to worry about elderly people and asthma patients," Perera says. "Now we worry about fetuses." And efforts to reduce environmental toxins can make a measurable difference, she says. "Over the years that we've been tracking exposures, New York City buses have switched to cleaner technology, and restrictions have been placed on the idling of diesel buses and trucks," Perera notes. "As a result, we've seen the levels of pollutants in pregnant women's blood coming down, which means their fetuses are encountering fewer of these substances too."

The Sources of Stress

At the farthest edge of fetal-origins research, scientists are exploring the possibility that intrauterine conditions influence not only our physical health but also our intelligence, temperament, even our sanity. Evidence indicates, for example, that pregnant women subjected to starvation or extreme stress give birth to children with a higher risk of schizophrenia. (See pictures of maternal mortality.)

Schizophrenia is a complex disorder with many potential causes. But a study based on 30 years of case records from Anhui province in China strongly suggests that prenatal factors can play a role. In the mid-20th century, residents of that region experienced severe malnutrition during the famine that accompanied the Great Leap Forward, Mao Zedong's disastrous modernization campaign. Individuals born to women suffering from the famine were twice as likely to develop schizophrenia as those gestated at other times. Likewise, a study of the health records of more than 88,000 people born in Jerusalem between 1964 and 1976 found that the offspring of women who were in their second month of pregnancy in June 1967 — the time of the Arab-Israeli Six-Day War — were significantly more likely to develop schizophrenia as young adults.

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Catherine Monk, an assistant professor of psychiatry at Columbia University, has advanced an even more startling proposal: that a pregnant woman's mental state can shape her offspring's psyche. "Research indicates that even before birth, mothers' moods may affect child development," Monk says. "Can maternal mood be transmitted to the fetus? If so, what is the mode of transmission? And how do such moods affect fetal development? These are new questions to be asking," she says. "We're still figuring out how to get fetuses to answer."

In fact, Monk and her colleagues have gone some way toward putting the fetus on the couch. At her lab, pregnant women who are depressed or anxious and pregnant women with normal moods are hooked up to devices that measure their respiration, heart rate, blood pressure and nervous-system arousal, as well as the movements and heart rate of their fetuses, and then subjected to challenging mental exercises. All of the women show physiological signs of stress in response to the tests, but only the fetuses of depressed or anxious women display disturbances of their own. (See why antidepressants and miscarriages are linked.)

"This difference suggests that these fetuses are already more sensitive to stress," Monk says. "Perhaps that's because of a genetic predisposition inherited from the parents. Or it could be because the fetuses' nervous systems are already being shaped by their mothers' emotional states." Women's heart rate and blood pressure, or their levels of stress hormones, could affect the intrauterine milieu over the nine months of gestation, Monk explains, influencing an individual's first environment and thereby shaping its development.

The differences Monk has found among fetuses appear to persist after birth. And because basic physiological patterns like heart rate are associated with more general differences in temperament, Monk says, "it may be that the roots of temperamental variation go back to the womb."

It could even be the case that a pregnant woman's emotional state influences her offspring's later susceptibility to mental illness. "We know that some people have genetic predispositions to conditions like depression and anxiety," Monk says. "And we know that being raised by a parent with mental illness can increase the risk of mental illness in the offspring. It may be that the intrauterine environment is a third pathway by which mental illness is passed down in families." This kind of research, says Monk, "is pushing back the starting line for when we become who we are."

Back to the Future
Ten years ago, when Matthew Gillman, a professor of population medicine at Harvard University, launched Project Viva — a study tracking more than 2,000 Boston-area children since they were fetuses — he knew he wanted to explore the effects of childhood experiences on later health. "But David Barker's research had started me wondering: When do these experiences really begin?" says Gillman. "I came to think they begin before birth, and so my study would have to start there too." Already the project has begun to illuminate the fetal origins of asthma, allergies, obesity and heart disease, as well as the role of gestational factors in brain development.

There are more revelations on the way. This year, the first of 100,000 pregnant women began enrolling in the National Children's Study, a massive, federally funded effort to uncover the developmental roots of health and disease. Researchers are conducting interviews with the women about their behaviors during pregnancy; sampling their hair, blood, saliva and urine; and testing the water and dust in their homes. The women and their children will be followed until the offspring turn 21, and the first results from the study, concerning the causes of premature births and birth defects, are expected in 2012.

Another line of research is developing interventions aimed at preventing disease. David Williams, a principal investigator at the Linus Pauling Institute at Oregon State University, is testing the notion that certain substances consumed during pregnancy can provide offspring with lifelong chemoprotection from illness. In Williams' studies, the offspring of mice that ingested a phytochemical derived from cruciferous vegetables like broccoli and cabbage during pregnancy were much less likely to get cancer, even when exposed to a known carcinogen. After they were weaned, the offspring in Williams' experiments never encountered these protective chemicals again, yet their exposure shielded them from cancer well into maturity. He predicts that one day, pregnant women will be prescribed a dietary supplement that will protect their future children from cancer. "It's not science fiction," he says. "I think that's where we're headed."

Knowledge gleaned from fetal-origins research may even benefit those of us whose births are in the past. "I always ask my adult patients what their birth weight was," says Mary-Elizabeth Patti, an assistant professor at Harvard Medical School and a physician-scientist at the university-affiliated Joslin Diabetes Center. "Patients are often surprised at the question — they expect me to ask about their current lifestyle. But we know that low-birth-weight babies become adults with a higher risk of diabetes, so having that information gives me a more complete picture of their case." Patti is researching how data about patients' birth weight could translate into tailored courses of treatment. (Can postpartum depression strike fathers?)

These possibilities may seem strange and surprising, but then the notion that we owe anything about our mature selves to our experiences during childhood was once considered preposterous too — before Sigmund Freud first pointed our attention to those formative years. With time and evidence, the idea that our health and well-being are shaped during gestation could also come to seem commonsensical. Perhaps our children, whose first snapshots were taken not in a hospital bassinet but inside a uterus, won't find the idea of fetal origins odd at all.

As for me, the baby in my belly for those nine months is now a sandy-haired toddler named Gus. Where did his particular qualities come from? Will he be strong or sickly, excitable or calm? What will his future hold? These are the questions parents have long pondered about their children. More and more, it looks as if many of the answers will be found in the womb.

Adapted from Origins: How the Nine Months Before Birth Shape the Rest of Our Lives, by Annie Murphy Paul, published in September by Free Press

Friday, October 1, 2010


There are two days in every week about which we should not worry.

Two days which should be kept free from fear and apprehension.

One of these days is yesterday with its mistakes and cares,

Its faults and blunders, Its aches and pains.

Yesterday has passed forever beyond our control.

All the money in the world cannot bring back yesterday.

We cannot undo a single act we performed.

We cannot erase a single word we said. Yesterday is gone.

The other day we should not worry about is tomorrow.

With its possible adversities, Its burdens,

Its large promise and poor performance.

Tomorrow is also beyond our immediate control.

Tomorrow's Sun will rise, either in splendor or behind a mask of clouds,

but it will rise.

Until it does, we have no stake in tomorrow, for it is yet unborn.

This just leaves only one day . . . Today.

Any person can fight the battles of just one day.

It is only when you and I add the burdens of those two awful eternity's -

yesterday and tomorrow that we break down.

It is not the experience of today that drives people mad.

It is the remorse or bitterness for something which happened yesterday

and the dread of what tomorrow may bring.
Let us therefore live but one day at a time.