The best features of this app are the scrolling data bank of feeling states, the library of cognitive distortions, and the reoccurring use of scales which let you rate intensity of a feeling or thought just by sliding your finger.

Run through of the app:

The “Activities Guide” lets you sort through what is the easiest and what is the hardest for you (socializing, exercising, sleeping, etc) and prioritize which areas to target first.

The “Thought Checker” section asks you to recount a situation that was difficult, describe how you felt and how much you felt that way.  This is basic Daily Thought Record material, but the app makes it easier for you by having a ready list of feelings to scroll through and choose and a sliding tool to measure the intensity of the feeling.  You then are asked to list your Automatic Thoughts in a clear and easy to understand manner.  From there the app takes you to a list of cognitive distortions (descriptions included) that you easily scroll through and click to choose.

A section titled “Mood” is a very simple but highly useful way to keep track of your daily mood.  It’s simply a number rating from 1-10 (1 the worst, 10 the best) that you scroll through and select.  You can add notes if you choose, but can also just quickly select a number.  The app will track the numbers and chart them for you providing a wonderful visual of your mood over time.

The “Journal” section is hard to use on an iphone (for those of us who have a hard time typing more than a couple sentences on the device) but easier on the larger ipad.  It is a section for recording notes about mood, activities, thoughts, etc.  This section is pretty standard.

Mood Kit is one of the best CBT apps I have seen.  The mood tracking ability (complete with graphs) is great, and the simplicity and ease of use make this app one that even the most reluctant user will have a hard time avoiding.  I have used this app myself and frequently recommend it to teens in my clinical practice.  To learn more go to: www.thriveport.com.

The app serves as a basic Daily Thought Record.  This app does not provide significant advantage over a pen and paper thought record for an experienced CBT user, but it may be useful for someone new to the ideas as it automatically generates lists of distortions to help the user identify and also creates on-going “thought lists.”  These thought lists have the potential to be very useful in identifying the frequent (automatic) thoughts that interfere, and helping the user to identify thought patterns.  The app also stores the data (passcode protected) thereby allowing the user to track changes and progress over time.

Overall, this is a good app for the user learning CBT techniques.  A more experienced user will appreciate the convenience of having it readily available on their phone, and the storage, but may find it too basic.  It can be viewed in the Apple app store and also at the website: http://www.cbtreferee.com.

I will focus on the more general CBT apps first and later go into more specific apps for phobias and other specific issues.

“CBT Referee” will be reviewed this week.

In the study (published this week in the American Sociological Review) binge drinking is defined as 5 or more alcoholic beverages in the same sitting.  The study found that binge drinking was influenced by factors including: best friend binge-drinking (30% more likely for your kid to drink if their best friend binge drinks) and by their boyfriend/girlfriend’s behavior (32% more likely to binge drink if their b/g binge drinks), but most significant was the finding that if your kid’s boyfriend/girlfriend’s peer group had a history of binge drinking your child was 81% more likely to binge drink themselves.

The authors of the study speculate that the teen feels the need to “cement” the relationship and sees the peer group as an essential step towards that end.  To read more about the study go to:

http://articles.latimes.com/2011/sep/30/news/la-heb-teen-alcohol-network-20110929

The newer research also isolated areas of the brain that play a role in the ability to delay gratification.  It appears that the prefrontal cortex was strongly linked to the people most able to delay gratification and the ventral striatum was very active in low delayers.  These physiological factors are significant, and help guide future research especially in the area of addictions.

• almost 2/3 of boys with ADHD had difficulty with writing (compared to 1 in 6 boys without the disorder)
• 57% of girls with ADHD had some type of writing problem (compared to less than 10% of their female peers without the disorder)
• Girls with ADHD were 10x more likely to have a combination of writing and reading disorders than their female peers without the disorder

Researchers are beginning to tease out what causes the greater difficulty and the theories range from the known working memory issues associated with ADHD to a motor skills issue.  Regardless, we need to look out for these issues and address them early in kids as writing is a cumulative skill that needs a strong foundation.

Pediatrics 2011; peds.2010-2581; Published online August 22, 2011 (10.1542/peds.2010-2581)

Newsweek just published an excerpt from a new book entitled Your Child Does Not Have Bipolar Disorder: How Bad Science and Good Public Relations Created the Diagnosis by Stuart Kaplan, MD.  Dr. Kaplan is a child and adolescent psychiatrist and a professor of psychiatry at Penn State, and his Newsweek article summarizes the rise of the diagnosis and the costs of this rise to children and families.  Dr. Kaplan notes:

• Outpatient office visits for children diagnosed with bipolar disorder increased from 20,000 annually in 1994–95 to 800,000 in 2002–03.  A 40-fold increase.
• Close to one third of all children and adolescents discharged from child psychiatric hospitals are now diagnosed with the disorder.
• 60-90% of children diagnosed with bipolar disorder have a comorbid (or co-existing) diagnosis of ADHD.  There is a long history of research that shows (when medicated appropriately) 80% of children with ADHD respond positively (and safely) to the stimulant.
• Most of the mood-stablizing medications used to treat bipolarity in youth are designed for adult use.  The side effects of the medications are significant and can range from weight gain to serious damage to liver and kidneys.

Dr. Kaplan ends his article with optimism; noting that the APA may include a diagnosis of temper dysregulation disorder in the new DSM.  This diagnosis may have less side effects for kids (in terms of stigma and medication) and lead to better, more appropriate treatment.  The Newsweek article is an important scientific and social stand; psychiatry is a medical profession based on scientific research and methods.  It also is a profession that is vulnerable to cultural fads.

To read the full article go to: http://www.newsweek.com/2011/06/19/mommy-am-i-really-bipolar.html

The author, Lori Gottlieb , is a practicing psychologist who explores the culture of self-esteem and happiness for our kids above all else.  She interviews some of the leading researchers on topics ranging from narcissism and social theory to look at how we got to this place (and I do wonder if we are starting to make changes in our culture that move away from this trend), as well as contemporary experts on child development.  The article is thoughtful and thought-provoking, and I encourage you to read it for yourself.

The best positive predictor for good developmental outcomes? An earlier bedtime from the start and greater sleep duration.

American Academy of Sleep Medicine (2011, June 15). Sleep loss in early childhood may contribute to the development of ADHD symptoms. ScienceDaily. Retrieved June 19, 2011, from http://www.sciencedaily.com/releases/2011/06/110614101122.htm