Category: Child Psychology

 After age 21, problem gambling is considerably more common among U.S. adults than alcohol dependence, even though alcohol dependence has received much more attention, according to researchers at the University at Buffalo's Research Institute on Addictions.

In results published this month in the Journal of Gambling Studies, John W. Welte, principal investigator on the study and a national expert on alcohol and gambling pathology, concluded that there is a distinct inconsistency between his research and much of the other research literature. Other research supports the proposition that problem gambling is more common among adolescents than among adults. Problem gambling has often been described as rare. Even the National Council on Problem Gambling describes it as "rare but treatable."

Welte and colleagues conducted, then combined, results from two national surveys of gambling and alcohol — one of youth ages 14-21 and the second of adults 18 and older — to identify patterns of U.S. gambling and alcohol use across the lifespan. They found that gambling, frequent gambling and problem gambling increases in frequency during the teen years, reaches its highest level in the 20s and 30s and then fall off among those over 70.

"No comparable analysis has been done previously and therefore none is available for a direct comparison of these results," Welte says. "But, given what we found about the persistence of frequent and problem gambling through adulthood, increased prevention and intervention efforts are warranted."

Other results detailed in the article demonstrate that frequent gambling is twice as great among men (28 percent) as among women (13 percent). Men reach their highest rates of both any gambling and frequent gambling in the late teens, while females take longer to reach their highest rates.

The odds of any gambling in the past year are significantly higher for whites than for blacks or Asians, although the odds of frequent gambling are higher for blacks and Native Americans, the study found.

It is also notable that frequent and problem gambling become more common as socioeconomic status (SES) gets lower; gambling involvement tends to decline as SES rises. Welte speculated as early as 2004 that lower SES Americans may pursue gambling as a way to make money, leading to more difficulties than if their motivation were strictly recreational.

Welte's first telephone survey of adult gambling was conducted in 1999-2000 with 2,631 adults from 4,036 households nationwide. The second survey of youth gambling in 2005-2007 included 2,274 youth — with parental permission — from 4,467 households. Both surveys were conducted with residents drawn from all 50 states and the District of Columbia. Questions asked of those who agreed to participate ranged from frequency of drinking, quantity and type of alcoholic beverage to frequency of past-year gambling and type of gambling, such as raffles, cards, casinos, sports betting, horse or dog track, lottery involvement and games of skill.

The UB RIA research team included Grace M. Barnes, senior research scientist, Marie-Cecile O. Tidwell, project manager, and Joseph H. Hoffman, statistician. The study was supported by funding from the National Institute on Mental Health.

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Journal Reference:

1. John W. Welte, Grace M. Barnes, Marie-Cecile O. Tidwell, Joseph H. Hoffman. Gambling and Problem Gambling Across the Lifespan. Journal of Gambling Studies, 2010; 27 (1): 49 DOI: 10.1007/s10899-010-9195-z

The death of parents entails an increase in their children's risk of dying. This is shown in a new study performed by Mikael Rostila, a researcher at the Center for Health Equity Studies (CHESS) in Sweden, and Jan Saarela, a researcher at Åbo Akademi University in Finland. Those especially affected are younger children, and primarily if they lose their mother.

"Among children between 10 and 18 years of age, there's an increased risk of death. Compared with children who have not lost their mother at these ages, their risk of dying is nearly doubled. But even children up to the ages of 40-50 are affected by their mother's death, but in that case primarily over a longer term," says Mikael Rostila. In other words, our parents are very important to us throughout our lives.

"The fact that it's primarily the loss of a mother that impacts children can be explained in different ways. It may be so that the relation between mother and child is characterized by a stronger emotional contact, entailing that the child is affected more by the loss. Other studies have shown that mothers transfer material and economic resources to their children to a greater extent than fathers do, which may have a positive effect on their health," says Mikael Rostila.

Somewhat surprisingly the findings of the study indicate that older children who lose a parent evince lower mortality than children whose parents are living.

"This may be because the parents' final stage of life brings with it a great deal of anxiety and caring and many elderly parents are in ill health for an extended period. Paradoxically, their death can be a relief to the child in that the parent no longer has to suffer," says Mikael Rostila.

The study also shows that death by accident or suicide, for example, has the greatest consequences for the health of children.

"This is rather to be expected in that the unexpected loss of a parent means that we find it more difficult to accept the loss. We have no time to prepare ourselves for the event. This entails a greater risk of winding up in a crisis or depression," says Mikael Rostila.

"The study's findings have important consequences for health care, as we have little knowledge of how death and illness in an individual impact the health of loved ones. In caring for an individual in the final stages of life, physicians and other health care staff should pay more attention to the perceptions and reactions of loved ones. It may also be important for health care to follow up individuals who are mourning the death of a loved one. This can reduce suffering, illness, and death among loved ones," says Mikael Rostila.

The study is based on a registry database from CHESS where it is possible to link together parents and children and thereby follow children up to 10 years after the loss of a mother or father.

A sleepless night can make us cranky and moody. But a lesser known side effect of sleep deprivation is short-term euphoria, which can potentially lead to poor judgment and addictive behavior, according to new research from the University of California, Berkeley.

Researchers at UC Berkeley and Harvard Medical School studied the brains of healthy young adults and found that their pleasure circuitry got a big boost after a missed night's sleep. But that same neural pathway that stimulates feelings of euphoria, reward and motivation after a sleepless night may also lead to risky behavior, their study suggests.

"When functioning correctly, the brain finds the sweet spot on the mood spectrum. But the sleep-deprived brain will swing to both extremes, neither of which is optimal for making wise decisions," said Matthew Walker, associate professor of psychology and neuroscience at UC Berkeley and lead author of the study.

The findings, published March 22, in the Journal of Neuroscience, underscore the need for people in high-stakes professions and circumstances not to shortchange themselves on sleep, Walker said.

"We need to ensure that people making high-stakes decisions, from medical professionals to airline pilots to new parents, get enough sleep," Walker said. "Based on this evidence, I'd be concerned by an emergency room doctor who's been up for 20 hours straight making rational decisions about my health."

The body alternates between two main phases of sleep during the night: Rapid Eye Movement (REM), when body and brain activity promote dreams, and Non-Rapid Eye Movement (NREM), when the muscles and brain rest. Previous brain studies indicate that these sleep patterns are disrupted in people with mood disorders.

Puzzled as to why so many people with clinical depression feel more positive after a sleepless night — at least temporarily — the researchers used functional Magnetic Resonance Imaging to study the brains of 27 young adults, half of whom got a good night's rest and the other half of whom pulled an all-nighter.

Participants viewed numerous images, including pleasant scenes (for example, bunnies or ice cream sundaes), and were asked to rate the pictures as either neutral or positive. Across the board, those who had skipped a night's sleep gave more positive ratings for all the images while the well-rested participants gave more moderate scores.

Moreover, brain scans of the participants who pulled all-nighters showed heightened activity in the mesolimbic pathway, a brain circuit driven by dopamine, a neurotransmitter that regulates positive feelings, motivation, sex drive, addiction, cravings and decision making.

While a bias toward the positive, potentially linked to a short-term boost in dopamine levels, may seem advantageous, it can be detrimental if people are making impulsive decisions because they're feeling overly optimistic, Walker said.

The findings build upon previous research by Walker and his team that shows sleep deprivation shuts down the brain's key planning and decision-making regions — namely the prefrontal cortex — while activating more primal neural functions such as the fight-or-flight reflex in the amygdala region of the brain.

The latest study shows a similar disconnect between the prefrontal cortex and the misolimbic pathway after a night of no sleep: "After a good night's sleep, the frontal lobe regions are strongly connected to the dopamine reward regions, but that's not the case after a night of no sleep," Walker said.

As for a therapy for people who are clinically depressed, sleep deprivation is not a viable solution, according to Walker: "The elastic band of sleep deprivation can only be stretched so far before it breaks," he said.

In addition to Walker, coauthors of the study are Ninad Gujar, a senior research scientist at UC Berkeley's Sleep and Neuroimaging Laboratory; Seung-Schik Yoo, associate professor of radiology at Harvard Medical School; and Peter Hu, a graduate student in psychology at the University of Chicago.

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Journal Reference:

1. N. Gujar, S.-S. Yoo, P. Hu, M. P. Walker. Sleep Deprivation Amplifies Reactivity of Brain Reward Networks, Biasing the Appraisal of Positive Emotional Experiences. Journal of Neuroscience, 2011; 31 (12): 4466 DOI: 10.1523/JNEUROSCI.3220-10.2011

A mother's iron deficiency early in pregnancy may have a profound and long-lasting effect on the brain development of the child, even if the lack of iron is not enough to cause severe anemia, according to a University of Rochester Medical Center study published in the scientific journal PLoS One.

The results are important because obstetricians might not notice or treat mild or moderate iron deficiency, and therefore the study authors believe their research underscores the need for monitoring a pregnant woman's iron status beyond anemia.

Low iron is so common that an estimated 35 percent to 58 percent of all healthy women show some degree of deficiency. And among women of childbearing age, one in five has iron-deficient anemia, a more serious condition, according to the National Institutes of Health.

It is well established that iron-deficient babies develop more slowly and show brain abnormalities such as slow language learning and behavioral problems. But until now investigators did not know the degree to which iron deficiency in pregnancy is associated with these impairments, and when during gestation the deficiency has the most impact on the central nervous system.

"What convinced us to conduct the present study were our preliminary data suggesting that cells involved in building the embryonic brain during the first trimester were most sensitive to low iron levels," said Margot Mayer-Proschel, Ph.D., the lead researcher and an associate professor of Biomedical Genetics at URMC.

Investigators, therefore, sought more details using a highly controlled animal model system, as it would not be feasible to study iron concentrations in developing human embryos. They found that the critical period begins in the weeks prior to conception and extends through the first trimester to the onset of the second trimester. Iron deficiency that starts in the third trimester did not seem to harm the developing brain.

"This information is very important for clinical care," said Monique Ho, M.D., a collaborator on the study and assistant professor of Obstetrics and Gynecology and Pediatrics at URMC. "Prenatal care usually involves the recommendation of a multivitamin that contains iron, which is usually prescribed after pregnancy is confirmed or at the first prenatal visit. But not all women have access to prenatal care, and not all women can take the supplements in early pregnancy due to vomiting. This study suggests it might be prudent to begin routine monitoring to detect iron deficiency earlier."

By studying the relationship between maternal iron intake and fetal iron levels through a diet study, the team was able to pin down the critical periods of gestation when the developing central nervous system was most vulnerable. They measured the resulting brain function using a common, non-invasive test called an auditory brainstem response analysis, or ABR.

Co-author Anne Luebke, Ph.D., an associate professor of Biomedical Engineering and Neurobiology & Anatomy at UR, suggested and directed the use of ABR testing, which can detect the speed of information moving from the ear to the brain. Investigators hoped to learn about impairments or changes in myelin, the insulating material that surrounds axons and is required for normal brain function.

"In addition, ABR testing is routinely performed on human infants, and thus our study has an important component that can be translated to a clinical setting," Luebke said.

The most surprising aspect of the research, Mayer-Proschel said, was that the timing of the iron deficiency was much more important than the degree of deficiency. This observation also seems to argue against the common notion that the placenta can minimize the impact of the mother's deficiency on the baby.

"We refer to this as the window of vulnerability," she said, "and it seems to be at a very early stage of development." In previous studies of the cellular targets of iron deficiency, Mayer-Proschel found that lack of iron sets off an imbalance of neural precursor cells, which might ultimately be responsible for the defects sometimes experienced by children up to age two.

"The next goals will be to better understand how maternal iron deficiency causes these changes in the offspring," she said, "and most importantly, what are the opportunities for reversing the damage."

The National Institutes of Health and the University of Rochester funded the research.

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Journal Reference:

1. Camelia Mihaila, Jordan Schramm, Frederick G. Strathmann, Dawn L. Lee, Robert M. Gelein, Anne E. Luebke, Margot Mayer-Pröschel. Identifying a Window of Vulnerability during Fetal Development in a Maternal Iron Restriction Model. PLoS ONE, 2011; 6 (3): e17483 DOI: 10.1371/journal.pone.0017483

Children with chronic inflammation of the middle ear can experience changes in their sense of taste, and these changes may be related to childhood obesity, according to a report in the March issue of Archives of Otolaryngology — Head & Neck Surgery, one of the JAMA/Archives journals.

Chronic otitis media with effusion is a persistent inflammation of the middle ear, in which effusion fluid is retained in the middle ear cavity. "Otitis media with effusion (OME) is a disease with a high incidence in childhood and is a common cause of hearing disturbances in children," the authors write as background information in the article. "Although most children have a good prognosis, 10 percent of affected children develop recurrent or persistent OME."

Il Ho Shin, M.D., of Kyung Hee University, Seoul, South Korea, and colleagues conducted a case-control study to evaluate the association between the taste threshold in patients with chronic otitis media with effusion (COME) and the relationship with body mass index. The authors hypothesized that changes in taste function may occur in children with COME and that such changes may be associated with body weight.

The researchers measured the taste thresholds of 42 children with COME who underwent insertion of a small plastic tube into the eardrum to keep the middle ear aerated, and a control group of 42 children without OME. Four standard taste solutions — sugar, salt, citric acid, and quinine hydrochloride — were used in chemical taste tests.

The authors found that children with chronic otitis media with effusion had a significantly higher body mass index (BMI) than those in the control group.

Test results showed taste thresholds on the anterior (front) part of the tongue were higher in children with COME than in the control group.

Chemical taste tests showed the thresholds of sweet and salty tastes were elevated for children in the COME group. The thresholds of bitter and sour taste were also somewhat higher in the otitis media group, but these differences were not statistically significant.

"These findings suggest an association between changes in taste and increased BMI in pediatric patients with COME," the authors conclude.

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Journal Reference:

1. I. H. Shin, D. C. Park, C. Kwon, S. G. Yeo. Changes in Taste Function Related to Obesity and Chronic Otitis Media With Effusion. Archives of Otolaryngology – Head and Neck Surgery, 2011; 137 (3): 242 DOI: 10.1001/archoto.2011.23

Although universal newborn hearing screening programs appear to identify children with hearing loss at a younger age, nearly one-third of pediatric cochlear implant recipients pass newborn screening only to be diagnosed later in infancy or early childhood, according to a report in the March issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.

"When universal newborn hearing screening programs (UNHS) were initially conceived, it was presumed that most hearing-impaired children, especially those without risk factors for progressive hearing loss, would fail the objective screening performed during the newborn period, thus making early diagnosis and intervention possible on a widespread basis," the authors write as background information in the study.

In Illinois, UNHS became mandated by law in 2003 for use in all birthing hospitals. Nancy Melinda Young, M.D., from Children's Memorial Hospital, Chicago, and colleagues examined data for 391 children who received cochlear implants in Illinois from 1991 through 2008. Implant patients were divided into those born before mandatory UNHS (264 children) and those born after the screening became legally required (127 children).

Children born after the law was implemented were screened at a much higher rate than those born before (85 percent vs. 32.6 percent). Of the 127 children born after the UNHS mandate, 83 (65.4 percent) had a known cause of or at least one risk factor for hearing loss, and 21 of those children (25.3 percent) passed hearing screenings.

Overall, children screened after the UNHS mandate were significantly younger at diagnosis of hearing loss, age at diagnosis of severe to profound hearing loss and age at implantation than children born prior to passage of the law. Additionally, children who failed screenings were diagnosed (average age 5.9 months) and underwent implantation (average age 1.7 years) significantly earlier than those who passed or were not screened as newborns.

"Almost one-third of our pediatric implant recipients pass UNHS and are older at the time of initial diagnosis and implantation than their peers who fail UNHS," the authors conclude. "Delayed onset of sensorineural hearing loss [hearing loss stemming from the inner ear or central processing centers in the brain] limits our ability to achieve early diagnosis and implantation of a significant number of deaf children."

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Journal Reference:

1. N. M. Young, B. K. Reilly, L. Burke. Limitations of Universal Newborn Hearing Screening in Early Identification of Pediatric Cochlear Implant Candidates. Archives of Otolaryngology – Head and Neck Surgery, 2011; 137 (3): 230 DOI: 10.1001/archoto.2011.4

 Alcohol use during pregnancy is common and is associated with significant threats to the health and development of exposed offspring. Despite warnings from the Surgeon General to limit alcohol use if pregnant or contemplating pregnancy, a recent survey by the National Birth Defects Prevention Study found that nearly one-third of women drank alcohol at some time during their pregnancy, with one-fourth of the women surveyed having drunk during the first trimester.

Heavy use of alcohol during pregnancy may lead to fetal alcohol syndrome which includes deficits in growth and central nervous system development. Fortunately, most women who drink alcohol during pregnancy are light to moderate drinkers, although consequences to the developing fetus still are of concern. The deleterious effect of prenatal alcohol exposure on 16 year old offspring is the subject of the article by Cynthia A. Larkby and colleagues in the March 2011 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).

In the study, researchers from the University of Pittsburgh School of Medicine and the University of Pittsburgh Medical Center examined 592 adolescents and their mothers or caretakers, utilizing data from a longitudinal study that evaluated prenatal substance exposure. The study began in 1982, and women were evaluated at their fourth and seventh prenatal months and with their children at birth, eight and eighteen months, and 3, 6, 10, 14, and 16 years postpartum. The quantity, frequency and pattern of alcohol use was summarized as average daily alcohol consumption and included beer, wine, and liquor. The study participants were 50% African American and 50% white.

Dr. Larkby and colleagues found that adolescents exposed to an average of one or more drinks of alcohol per day in the first trimester of pregnancy were three times more likely to meet criteria for a lifetime diagnosis of conduct disorder than were adolescents whose mothers drank less than that amount or abstained. The association of prenatal alcohol exposure and conduct disorder was not linear and the association was significant only at or above the level of one alcohol drink per day during the first trimester.

By the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria, conduct disorder is a pattern of severe behavior problems persisting for month than 12 months that include aggression toward persons and animals, destruction of property, deceitfulness or theft, and serious rule violations.

In conclusion, Larkby and colleagues state, "From a clinical perspective, prenatal alcohol exposure should be considered as another risk for conduct disorder. The next steps in research should be to define the interactions between prenatal exposures, environmental factors, and heritability. This would allow a more complete picture of the relations between prenatal alcohol exposure and conduct disorder."

This research reported in this article was funded by the National Institute of Alcohol Abuse and Alcoholism grants AA00312 (C.L.) and AA07666 (N.D.), and the National Institute on Drug Abuse grant DA03874 

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Journal Reference:

1. Cynthia A. Larkby, Lidush Goldschmidt, Barbara H. Hanusa, Nancy L. Day. Prenatal Alcohol Exposure Is Associated With Conduct Disorder in Adolescence: Findings From a Birth Cohort. Journal of the American Academy of Child & Adolescent Psychiatry, 2011; 50 (3): 262 DOI: 10.1016/j.jaac.2010.12.004

Canadians have one of the highest rates of Multiple Sclerosis (MS) in the world with approximately 1,000 new cases diagnosed each year. Primarily striking in adulthood, physicians and researchers with the Canadian Pediatric Demyelinating Diseases Network (CPDDN), a multi-institutional and multidisciplinary group, have found that MS is being increasingly diagnosed in children. A study by the CPDDN published in the journal Neurology, identifies a particular gene involved in the immune response that puts certain children at a higher risk of developing MS.

In children, an initial attack of demyelination (acquired demyelinating syndrome [ADS] in the central nervous system) often remains a single, isolated episode. However, in at least 20 % of children it represents the first clinical attack of MS. This contrasts with adult-onset MS, where most individuals presenting with acute demyelination are subsequently diagnosed with MS. Demyelination is the destructive loss of myelin — the protective covering that insulates and supports nerve cells — damaging the cells' ability to receive and transmit signals in the body.

"The uncertainty of the diagnosis understandably creates a lot of anxiety for children and their families," says Dr. Amit Bar-Or, neurologist and lead investigator at The Montreal Neurological Institute and Hospital — The Neuro, McGill University. "Having the tools to distinguish ADS and MS is important." Researchers at The Neuro in collaboration with researchers at the SickKids in Toronto and international colleagues therefore wanted to identify the risk factors in the 20% of children who go on to develop MS, and to investigate if the risk factors and the disease biology are the same in both children and adults.

In adults, complex interactions between genetic and environmental factors contribute to risk and the best established genetic susceptibility marker has been identified in the alleles of the major histocompatability complex, a family of genes that play an important role in the immune system and autoimmunity. Specifically, the genetic risk factor for adults of northern European origins is localized to a form of the gene known as the HLA-DRB1 allele. The researchers wanted to verify if this allele predicts MS in at-risk children with ADS. Children, aged 16 or younger (266 children with ADS and 196 healthy controls) provided blood samples for genetic analysis.

"What we found is that there is a higher frequency of HLA-DRB1 in children that would later be diagnosed with MS, but not in children presenting with a single episode of ADS. This indicates that this gene is a risk factor in pediatric-onset MS." Children with ADS that do not go on to develop MS had no difference in HLA gene expression from controls indicating that the gene confers an increased risk for pediatric-onset MS, but not for acquired demyelination in general.

This is one of several studies investigating pediatric MS as part of the CPDDN. As children with pediatric MS are closer to the early mechanisms and biology of the disease, they can also provide insights into factors that represent causes versus consequences of the disease. One in 20 adults with MS can trace the disease back to a pediatric event, and therefore have had the disease for many years. This study reveals a fundamental similarity in genetic contribution to MS risk in both pediatric and adult-onset disease and underscores the importance of understanding the etiology of MS in children providing the possibility for earlier diagnoses and intervention and hopefully new therapies for MS.

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Journal Reference:

1. G. Disanto, S. Magalhaes, A. E. Handel, K. M. Morrison, A. D. Sadovnick, G. C. Ebers, B. Banwell, A. Bar-Or. HLA-DRB1 confers increased risk of pediatric-onset MS in children with acquired demyelination. Neurology, 2011; 76 (9): 781 DOI: 10.1212/WNL.0b013e31820ee1cd

Depression in fathers can negatively affect a young child's health and development.  Compared to their non-depressed counterparts, depressed fathers are nearly four times more likely to report spanking their child. Depressed dads are also less likely to read to their children.

Those are the results of a new study to be published in the April print issue of Pediatrics, by University of Michigan Health System researchers. The study was led by R. Neal Davis, a former fellow at the University of Michigan Health System's Child Health and Evaluation Research (CHEAR) Unit in the Division of General Pediatrics. He is now a pediatrician at Intermountain Healthcare in Murray, Utah.

The researchers studied data from 1,746 fathers of 1-year-old children in the Fragile Families and Child Wellbeing Study. Fathers reported on how often they played with, sang to and read to their kids. They also reported whether they had spanked their kids in the last month and whether they had spoken to their child's medical provider in the past year. The fathers were also assessed for depression.

Overall, 7 percent of fathers had depression. Of those, 41% said they read to their child at least three times a week, compared with 58% of fathers who weren't depressed. Forty-one percent of fathers said they had hit their child in the last month — over three times as many as fathers who weren't depressed.

"The effect of mothers' depression on parenting behaviors has been well established," said Sarah Clark, senior author on the study. "This study is important because it demonstrates that depression in fathers has very tangible effects on how those fathers interact with their young children."

The findings also offer an important cue to action, as over three quarters of depressed fathers reported talking to their child's doctor in the previous year. "This suggests that visits to the pediatrician may provide an ideal opportunity to discuss specific parenting behaviors with fathers and to refer depressed fathers for appropriate treatment," says Davis.

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Journal Reference:

1. R. N. Davis, M. M. Davis, G. L. Freed, S. J. Clark. Fathers' Depression Related to Positive and Negative Parenting Behaviors With 1-Year-Old Children. Pediatrics, 2011; DOI: 10.1542/peds.2010-1779

 Providing information on your music consumption publicly can change it. A small study finds that people are willing to put a lot of effort into maintaining a desirable public image, yet they also want to be truthful.

When information about music preferences is published automatically, youth and young adults are reluctant to digitally "cheat" about their musical choices. Instead, they change the music they listen to.

Suvi Silfverberg, Lassi A. Liikkanen and Airi Lampinen from Helsinki Institute for Information Technology HIIT studied the experience of maintaining a profile in the online music service Last.fm. Twelve Finnish youth and young adults where interviewed on their use of this music-focused social network service and its extension, called "the scrobbler," that publishes information of music listened to by service users.

The researchers found that people make active efforts to control the image their online profile gives of them, especially when their music listening is published automatically. While automated sharing of behavior information provides new opportunities for online music services, it also affects the people listening to music.

"When an online service publishes behavioral information automatically, it is important to give users a chance to express and explain the meanings of their actions. Listening to a song doesn't necessarily mean that one likes it — or wants to be known as the kind of person who does," says Liikkanen.

The study will be published in the 2011 ACM Conference on Computer Supported Cooperative Work in March in Hangzhou, China.