Frasier Crane and his brother, Niles, both practiced psychiatry on their popular NBC sitcom “Frasier.” Mob boss Tony Soprano had his therapist on HBO’s hit show “The Sopranos.” And HBO has even made therapy the focus of two recent shows — “Tell Me You Love Me” and “In Treatment.”

But all of these TV portrayals may actually make viewers less likely to seek psychological services themselves. That’s according to a new study by three Iowa State University psychologists.

ISU psychology professors David Vogel and Douglas Gentile collaborated with graduate student Scott Kaplan on the study of 369 Iowa State students. It explored how exposure to television shows may contribute to negative perceptions about psychological services that can lead to lower intentions to seek such services. They produced a paper titled “The Influence of Television on Willingness to Seek Therapy,” which was published in the March issue of the Journal of Clinical Psychology, a professional journal.

Unflattering portrayals of mental health professionals

Kaplan has conducted a related content analysis on television portrayals of mental health professionals. It found that they’re not favorable.

“Generally, it seems like therapists are portrayed unethically — like sleeping with the client, or implanting false memories, or talking about their clients outside the session,” Vogel said. “These are things that almost never happen with real therapists, but on a show — because they’re probably more exciting — they happen more frequently.”

“Therapists also often are portrayed as buffoons,” Gentile said. “That’s either by being the jokester, like Frasier, or by being the butt of jokes. In either case, these are not positive portrayals. They do not show the skill, expertise and ethics of professional therapists.”

But it’s not just the portrayal of the therapists that may be keeping people out of therapy. It’s also the portrayal of those who seek counseling on TV.

“If you examine the portrayal of the clients, it’s probably as bad or worse,” Vogel said. “So why would you seek therapy if you believe you’re going to be perceived negatively and you’re going to see someone who’s incompetent and not able to help you?”

Because dramas and comedies are the two types of shows that often portray psychologists and psychotherapy, the ISU psychologists asked respondents how often they watched TV comedy and drama shows. They also asked them to assess perceptions of the stigma associated with seeking professional help, attitudes toward therapy, their intentions to seek therapy for psychological and interpersonal concerns, and their feelings of depression.

TV ties to therapy stigma

The study found a positive correlation between viewers’ exposure to comedy and drama shows and their perceptions of stigma associated with seeking professional help. This stigma was then related to lower willingness to seek professional mental health services.

“One of the things that’s important to note about this particular study is that we showed that TV exposure was related to your perceptions of the stigma associated with seeking help, which has been found to be one of the main factors found from inhibiting people from seeking that help,” Vogel said. “So you perceive that yourself, and other people, would be crazy to go (to therapy).”

That’s a problem for those people who could really benefit from professional mental health services. According to Vogel, the most recent studies in the mental health field have found that about half of population experiences a situation in their lives where psychological therapy could be helpful — about 20 percent in a single year. But in a given year, only about 10 percent of the people who could benefit from therapy will seek help from a psychologist or other mental health professional.

“Mental health services are already vastly underutilized, and this cultural stigma is part of the reason,” Gentile said. “And this study suggests that this cultural stigma exists partly because of the way that psychologists and their patients are portrayed on television.”

[Mike Ferlazzo @ Iowa State University]

But it’s not just weight gain that poses a risk. People who are underweight also have an elevated risk of dementia, unlike people who are normal weight or overweight.

US researchers carried out a detailed review of 10 international studies published since 1995, covering just over 37,000 people, including 2,534 with various forms of dementia. Subjects were aged between 40 and 80 years when the studies started, with follow-up periods ranging from three to 36 years.

The review, which included studies from the USA, France, Finland, Sweden and Japan, also included a sophisticated meta-analysis of seven of the studies, published between 2003 and 2007 with a follow-up period of at least five years.

All kinds of dementia were included, with specific reference to Alzheimer’s Disease and to vascular dementia — where areas of the brain stop functioning because the blood vessels that supply them are damaged by conditions such as high blood pressure or heart disease.

“Our meta-analysis showed that obesity increased the relative risk of dementia, for both sexes, by an average of 42 percent when compared with normal weight” says Dr Youfa Wang, Associate Professor of International Health and Epidemiology at Johns Hopkins Bloomberg School of Public Health, Baltimore.

“And being underweight increased the risk by 36 percent.

“But when we looked specifically at Alzheimer’s Disease, the increased risk posed by obesity was 80 percent. The increased risk for people with vascular dementia was 73 percent.

“The risks were greater in studies where sufferers developed Alzheimer’s Disease or vascular dementia before the age of 60 or in studies with follow-up periods of more than 10 years.

“We also found that obesity was more likely to be a risk factor for women when it came to developing Alzheimer’s Disease and for men when it came to vascular dementia.”

The authors estimate that 12 percent of the dementia risk in the study population could be attributed to obesity, with this rising to just over 21 percent in patients with Alzheimer’s Disease.

It’s estimated that up to 10 percent of people aged 65 or more suffer from some form of dementia and two-thirds of those have Alzheimer’s Disease.

“There has been controversy about the links between obesity and dementia for a number of years, but previous findings have been mixed and inconclusive” says Dr Wang.

“The advantage of carrying out a meta-analysis is that it provides researchers with access to a large number of study subjects and it is possible to iron out the inconsistencies and come to overarching conclusions.

“Our detailed analysis clearly shows a U-shaped relationship between weight and dementia, with people who are obese or underweight facing a greater risk.

“We believe that our results show that reducing the prevalence of obesity is a promising strategy for preventing the progression of normal ageing into Alzheimer’s Disease.”

[Annette Whibley @ Wiley-Blackwell]