The Intelligent Clinician’s Guide to the DSM-5: an Interview with Dr Joel Paris from Clinton Power on Vimeo.

I must commend my colleague Clinton Power of Australian Counselling for this most excellent interview with Dr. Joel Parish.

Dr. Joel Paris is a research associate at the Sir Mortimer B. Davis Jewish General Hospital in Montreal. Since 1994 he has been a full professor at McGill University and served as chair of its Department of Psychiatry from 1997 to 2007. He has supervised psychiatric evaluation with residents for over 30 years and has won many awards for his teaching. Dr. Paris is a past president of the Association for Research on Personality Disorders. Over the last 20 years, he has conducted research on the biological and psychological causes and the long-term outcome of borderline personality disorder. Dr. Paris is the author of 183 peer reviewed articles, 40 book chapters and15 books. He’s also editor-in-chief of the Canadian Journal of Psychiatry. Most recently, he’s the author of the book, ‘Treatment of Borderline Personality Disorder: A Guide to Evidence-Based Practice’ amzn.to/14Y7Q22 and his latest book is called ‘The Intelligent Clinician’s Guide to the DSM 5’ amzn.to/YfD8N2

PS~ You can pre-order the new DSM-5 here: amzn.to/161bQPo

ᔥ Australian Counselling

With Mother’s Day on the horizon, what is it that makes for the special bond between a mother and her sons? From the moment I held each of my sons in my arms I vowed that nothing would come between me and my child. So what is it that makes for the essential qualities of a continuing close bond between mother and son?

A mother’s trait of simply “being there” was mentioned most frequently by young men as critical in how close they were to their moms — whether that meant talking about romance, discussing faith or picking a college major, according to a Baylor University researcher.

The new TV series Bates Motel (inspired by Alfred Hitchcock’s Psycho) is provoking talk about mothers and sons, it’s a good time to consider what makes for closeness (or not) in that parent-child bonding, says Mark T. Morman, Ph.D., a professor of communication studies in Baylor’s College of Arts and Sciences.
Conversation is crucial in bonding between mothers and sons, with the most prominent topic that of relationships, said Morman, whose study on the topic was published in the Journal of Family Communication in 2012.

That’s very different from father-daughter relationships, which tend to revolve around such shared activities as sports, he said.
Mothers also mentioned “social support” as vital to their connection with sons, Morman said.
“There are a variety of reasons to believe that mothers specifically influence their sons in a host of significant ways” — including on such issues as antisocial behavior, use of alcohol and suicidal thoughts, he said.

For the most part, mothers and sons in the study were in “remarkable agreement” about incidents they saw as critical — among them social support, family crisis, divorce, son maturing and son leaving for college or becoming physically distant for another reason, Morman said.
Here’s a look at incidents that are pivotal:

“BEING THERE”

One son wrote that when he got into a fight in high school, “this created a lot of tension between my dad and myself. My mother helped communicate between us, and she was understanding of my situation. I was able to confide in her, and we have been close ever since.”
Another said he grew close to his mother as she helped him lose a great deal of weight in elementary school.
For another son, “the biggest moment was probably struggling with my faith in high school and being able to communicate with my mom.”
Support during or after a breakup with a girlfriend was mentioned by several sons.
In one case, a son’s choice of girlfriend caused strain for the mother. “However, that relationship eventually ended, allowing him to meet and marry the wonderful young lady that is now an amazing part of our family,” the mother said.

HARD TIMES

Family crisis —such as illness, injury, death or problems with the authorities — emerged as the second largest category of responses among sons and mothers, with several men mentioning times when their mother’s health was at stake.
“My mother was diagnosed with a rare form of cancer two years ago,” one young man related. “I was a junior in high school, and I became distinctly aware that I could lose my mom forever.”
One mother recalled a time she yelled at her son and humiliated him because he did not seem to be trying during homeschooling. “He began to cry and said that he was stupid. At that point I knew that I was the stupid one . . . I realized that his spirit was more sensitive than I knew. It made me love him and be careful to affirm him much more after that.”

OUT OF THE NEST

Physical distance — such as when a son left for college — was the category that drew the third largest response for sons, with many reporting the miles actually brought them emotionally closer. “Something like, ‘you don’t know what you have until it’s gone,’” one son wrote.

A SON’S A SON TILL HE TAKES A WIFE

For mothers, meanwhile, a son’s marriage was the third most frequent pivotal time, with other changes in closeness occurring when a son matured, went to college or became a father. One woman said that her son’s marriage to “the perfect daughter-in-law” made it easy to stay close, but “in a different way.” Another woman said her “strained relationship” with her son changed when he joined the military — “mainly because the Army helped him to grow and mature as a young man.”

DISCORD

Conflict, whether in shouting matches or the silent treatment, sometimes drove mothers and sons apart, but it often had an upside as they worked through differences.
“I became close to my mother in high school when she caught me sneaking out of the house to go hang out with friends,” one son wrote. “At first, it distanced us. But as I came to realize her forgiveness, my relationship with her became closer.”
On a side note, conflict resolution sometimes takes an unusual twist — as in with the young man who invited his mother along on the senior trip. To find out more about that — and about romance as a talking point between moms and sons — view embedded videos with Morman at: http://www.baylor.edu/mediacommunications/news.php?action=story&story=129291

***STUDY METHODOLOGY

Study participants were 139 sons and 68 unrelated mothers, with the sons being at least age 18. Mothers were asked to write about a memorable time they shared with their sons, while sons were asked to relate one about their mothers.
Analysis of the sons’ responses produced a total of 130 different items, with most reporting only one critical incident. Mothers’ responses totaled 72 items. While many reported only one incident, others reported multiple events.

ᔥ Baylor University

A cup of beetroot juice a day may help reduce your blood pressure, according to a small study in the American Heart Association journal Hypertension.

People with high blood pressure who drank about 8 ounces of beetroot juice experienced a decrease in blood pressure of about 10 mm Hg. But the preliminary findings don’t yet suggest that supplementing your diet with beetroot juice benefits your health, researchers said.

“Our hope is that increasing one’s intake of vegetables with a high dietary nitrate content, such as green leafy vegetables or beetroot, might be a lifestyle approach that one could easily employ to improve cardiovascular health,” said Amrita Ahluwalia, Ph.D., lead author of the study and a professor of vascular pharmacology at The Barts and The London Medical School in London.

The beetroot juice contained about 0.2g of dietary nitrate, levels one might find in a large bowl of lettuce or perhaps two beetroots. In the body the nitrate is converted to a chemical called nitrite and then to nitric oxide in the blood. Nitric oxide is a gas that widens blood vessels and aids blood flow.

“We were surprised by how little nitrate was needed to see such a large effect,” Ahluwalia said. “This study shows that compared to individuals with healthy blood pressure much less nitrate is needed to produce the kinds of decreases in blood pressure that might provide clinical benefits in people who need to lower their blood pressure. However, we are still uncertain as to whether this effect is maintained in the long term.”

The study involved eight women and seven men who had a systolic blood pressure between 140 to 159 millimeters of mercury (mm Hg), did not have other medical complications and were not taking blood pressure medication. The study participants drank 250 mL of beetroot juice or water containing a low amount of nitrate, and had their blood pressure monitored over the next 24 hours.

Blood pressure is typically recorded as two numbers. Systolic blood pressure, which is the top number and the highest, measures the pressure in the arteries when the heart beats. Diastolic blood pressure, the bottom and lower number, measures blood pressure in the arteries between heart beats.

Compared with the placebo group, participants drinking beetroot juice had reduced systolic and diastolic blood pressure — even after nitrite circulating in the blood had returned to their previous levels prior to drinking beetroot. The effect was most pronounced three to six hours after drinking the juice but still present even 24 hours later.

In the United States, more than 77 million adults have diagnosed high blood pressure, a major risk factor for heart diseases and stroke. Eating vegetables rich in dietary nitrate and other critical nutrients may be an accessible and inexpensive way to manage blood pressure, Ahluwalia said.

Getting people to eat more fruits and vegetables is challenging, but results of the study offer hope, she said. “In the U.K., the general public is told that they should be eating five portions of fruit or vegetables a day but this can be hard to do. Perhaps we should have a different approach to dietary advice. If one could eat just one (fruit or vegetable) a day, this is one more than nothing and should be viewed as positive.”

The USDA recommends filling half your plate with fruits and vegetables, and the American Heart Association recommends eating eight or more fruit and vegetable servings every day.

Co-authors are Suborno M. Ghosh, B.Sc.; Vikas Kapil, M.A., M.B.B.S., M.R.C.P.; Isabel Fuentes-Calvo, Ph.D.; Kristen J. Bubb, Ph.D.; Vanessa Pearl; Alexandra B. Milsom,BSc PhD; Rayomand Khambata, B.Sc., Ph.D.; Sheiva Maleki-Toyserkani, B.Med.Sci.; Mubeen Yousuf, B.Med.Sci.; Nigel Benjamin, M.D., F.R.C.P.; Andrew J. Webb, Ph.D., M.R.C.P.; Mark J. Caulfield, M.D., F.R.C.P.; and Adrian J. Hobbs, B.Sc., Ph.D. Author disclosures are on the manuscript.

ᔥAmerican Heart Association