Dietary fat is necessary for mental and physical health. Excessively lean diets may be mentally and physically unhealthy. A balanced diet, with abundant fruits and vegetables, at least 30% of calories coming from fat, and with carbohydrates coming from foods with a lower glycemic index (e.g. reducing amounts of simple sugars), is probably a sound recommendation for good physical and mental health.
The type of fat is important, though: trans-fats are particularly harmful (these are from hydrogenated oils including hydrogenated margarines). It is probably true that omega-6 fatty acids (present in vegetable or soybean oils), while necessary in moderation, are over-abundant in western diets. Saturated fats (such as from red meat and dairy) have been associated with worse health outcomes.
Yet, as I review the literature, I see that this assumption about saturated fat may not be as clear as what most people assume. I intend to review this literature more thoroughly, and add to this post later. It may be that saturated fats from plant foods such as coconut are more benign. And it may be that health problems associated with eating a lot of red meat are due to factors aside from the saturated fat content.
*As I look into the coconut oil issue, I see there is a tremendous amount of hype and salesmanship going on--it seems to be touted as some kind of miracle food, also with a variety of scientific claims (e.g. about medium-chain triglyceride content) intended to strengthen the persuasion. When I look into what the research literature has to say, there really isn't a lot out there. What is out there at this point is not very consistent. It is true that there are groups of people, such as in Polynesia, who consume a lot of coconut oils, apparently without developing high rates of heart disease. In any case, I think it is fair to say that coconut or coconut oil in small quantities could be reasonably included in a healthy diet.
Clearly healthy sources of fat include fish, olive oil, nuts, avocados, and canola oil.
There are several types of cholesterol in the blood, the main subtypes being LDL and HDL. High LDL is a risk factor for cardiovascular disease (e.g. heart attacks and strokes). HDL is considered "the good cholesterol", and it is quite clear that higher HDL levels reduce the risk of developing cardiovascular disease. It is possible to increase HDL by exercising regularly, maintaining a healthy weight, stopping smoking, increasing dietary intake of monounsaturated fat (e.g. olive oil & canola oils), and increasing soluble fiber in the diet (e.g. oats, fruits, vegetables, legumes). 1-2 drinks per day (but no more) of alcohol may favourably impact HDL levels and overall health. It is important to note that the actual cholesterol present in certain foods, such as eggs, has an inconsistent relationship with serum cholesterol levels (perhaps a stronger relationship in some people than others), and an even less consistent effect on health variables--so cholesterol content of foods need not be a particularly important variable to assess.
(reference:http://www.ncbi.nlm.nih.gov/pubmed/18726564
In this 1998 study from the British Journal of Nutrition, subjects initially consumed a diet with 41% of calories coming from fat, then half of these subjects switched to a low-fat diet with only 25% of calories from fat. The group with the lower-fat diet developed higher levels of anger, hostility, and anxiety compared to the group continuing the higher-fat diet:
http://www.ncbi.nlm.nih.gov/pubmed/9505799
In this 2008 meta-analysis from Annals of Behavioural Medicine, an inverse association is found between serum cholesterol levels and depression. It is an interesting and surprising finding, given that we recognize lower cholesterol levels as beneficial for your heart:
http://www.ncbi.nlm.nih.gov/pubmed/18787911
In this 2008 study, a group with chronic depression was compared with a group with normal mood, and it was found that depression was associated with lower HDL levels (i.e. lower "good cholesterol"), even after controlling for several confounding factors. This type of study is unfortunately a bit weak. Here's a link to the abstract:
http://www.ncbi.nlm.nih.gov/pubmed/18583011
Here's a reference to a 2003 article from Encephale reviewing some of the evidence about low cholesterol being associated with depression and suicide. The authors also suggest that inadequate omega-3 fatty acids compared to omega-6 fatty acids in the diet may be a contributing factor to higher rates of depression.
http://www.ncbi.nlm.nih.gov/pubmed/12640327
This is a small but convincing 2008 study which showed significantly lower cholesterol levels in suicidal patients with schizoaffective disorder, compared to non-suicidal patients with schizoaffective disorder, and compared to healthy controls. HDL (the "good cholesterol") was higher in the non-suicidal patients and in the control group. The groups did not differ significantly with respect to BMI, so the association between cholesterol and symptoms would not have been due to weight.
http://www.ncbi.nlm.nih.gov/pubmed/17850945
Here's another 2007 study showing low cholesterol levels in an elderly group with cognitive impairment, and in an elderly group with depression, compared to a healthy elderly group.
http://www.ncbi.nlm.nih.gov/pubmed/17712096
Here's a 2007 study showing strong association between higher HDL cholesterol and better physical functioning among the oldest elderly (over 80 years old):
http://www.ncbi.nlm.nih.gov/pubmed/17913756
Here's a 2004 review describing the many findings about higher HDL being associated with better physical and mental functioning in the elderly, and in particular that people who live over 100 years have higher HDL levels:
http://www.ncbi.nlm.nih.gov/pubmed/15557706
In this strong, prospective 2009 study following 1,468 nurses with type II diabetes, higher dietary saturated and trans fat intake, and a lower ratio of polyunsaturated fat to saturated fat in the diet, was associated with worse cognitive decline (those in the highest third of saturated+trans fat intake effectively aged an extra 7 years with respect to cognitive decline, compared to those in the lowest third):
http://www.ncbi.nlm.nih.gov/pubmed/19336640
Here's a similar 2004 article from Neurology showing worse cognitive decline associated with higher saturated fat intake, lower monounsaturated fat intake, and a lower ratio of polyunsaturated to saturated fat intake:
http://www.ncbi.nlm.nih.gov/pubmed/15136684
In this strong, prospective, randomized 2007 study from JAMA, a diet with a low glycemic load (e.g. reducing simple sugars and increasing complex, slowly-digested carbs) and 35% of energy coming from fat, was compared with a low-fat diet (20% of energy from fat), with follow-up over 18 months. The higher-fat, low-glycemic load diet led to better improvement (increase) of HDL levels, and considerably better weight control:
http://www.ncbi.nlm.nih.gov/pubmed/17507345
Thursday, April 30, 2009
Wednesday, April 22, 2009
Studying & Practicing Techniques
The field of optimizing study or practice time is quite interesting. There are elements of wisdom from diverse points of view, such as from athletic trainers & coaches, elementary and high school teachers, musicians, and educational psychologists.
Here are a few ideas:
1) make a commitment to spend regular, frequent periods of time in study or practice
2) make your study or practice time interesting or fun
3) if your attention is failing, try to compete with yourself gently (e.g. put a mark on your page if you catch your attention wandering off); but also allow yourself brief breaks. In order to control this process (and to prevent your brief break from becoming a 6-hour break), you could use a timer. During breaks, you could rest quietly or go for a walk, perhaps reviewing in your mind some of what you have just learned. During periods of decreased attention, you may need to allow for more frequent breaks.
4) frequent review helps with memory consolidation. If you have just learned something, go back right away to remind yourself of it--maybe ask yourself, and answer to yourself, a few questions about it, rather than immediately plowing ahead with the next chapter.
5) Sleeping after learning improves consolidation of memory. Slow-wave sleep, which tends to occur in the first few hours after you fall asleep, is particularly important for memory consolidation. In one clever 2007 study published in the presitigious journal Science, subjects were exposed to an odor when learning a task. If they were exposed to that same odor during subsequent slow-wave sleep, their retention of the learning task was significantly improved. Here's the reference:
http://www.ncbi.nlm.nih.gov/pubmed/17347444
This suggests a simple aromatherapy technique to enhance your studying: infuse your study environment with a distinct, pleasant fragrance (for example, try an aromatherapy oil) -- then infuse your pillow with the same fragrance afterwards. During an exam or test, try infusing the same fragrance on your skin or clothes (just don't overdo it, or you might irritate the people writing their exams next to you!)
Furthermore, there is evidence that brief naps (60-90 minutes) in the middle of the day can help with memory consolidation, motor learning, and can also prevent the deterioration of mental and physical performance which tends to happen in a long day. Here is one reference about this:
http://www.ncbi.nlm.nih.gov/pubmed/12819785
6) choose a study or practice environment which is psychologically pleasing. This could include multi-sensory environmental manipulation, including access to healthy foods, smells, comfortable seating, quietness, soothing background noise, etc.
7) if part of the learning task requires repetition, make special effort to infuse the repetition with something imaginative.
8) if part of the practice is for exam preparation, etc. then you could try to mimic the exam environment repeatedly--e.g. by doing mock exams at the same time of day as the scheduled exam, or by doing these practices in the same physical location as the actual exam, if possible.
9) if the practice is for a performance, it can help to record yourself periodically; when you hear or look at your recording you may need to be critical but you should also consciously affirm the aspects of your performance that went well. Self-criticisms should never be in the form of a personal attack (e.g. "I'm stupid!") but should be gentle observations of areas to work on or change.
10) a tutor could be quite helpful, not merely to "teach you" but as a motivational figure to help you practice or study more efficiently or with greater enjoyment (along the lines of a personal trainer for fitness). A friend or study partner could have this type of role, provided the friend does not become a distraction from your work.
Here are a few ideas:
1) make a commitment to spend regular, frequent periods of time in study or practice
2) make your study or practice time interesting or fun
3) if your attention is failing, try to compete with yourself gently (e.g. put a mark on your page if you catch your attention wandering off); but also allow yourself brief breaks. In order to control this process (and to prevent your brief break from becoming a 6-hour break), you could use a timer. During breaks, you could rest quietly or go for a walk, perhaps reviewing in your mind some of what you have just learned. During periods of decreased attention, you may need to allow for more frequent breaks.
4) frequent review helps with memory consolidation. If you have just learned something, go back right away to remind yourself of it--maybe ask yourself, and answer to yourself, a few questions about it, rather than immediately plowing ahead with the next chapter.
5) Sleeping after learning improves consolidation of memory. Slow-wave sleep, which tends to occur in the first few hours after you fall asleep, is particularly important for memory consolidation. In one clever 2007 study published in the presitigious journal Science, subjects were exposed to an odor when learning a task. If they were exposed to that same odor during subsequent slow-wave sleep, their retention of the learning task was significantly improved. Here's the reference:
http://www.ncbi.nlm.nih.gov/pubmed/17347444
This suggests a simple aromatherapy technique to enhance your studying: infuse your study environment with a distinct, pleasant fragrance (for example, try an aromatherapy oil) -- then infuse your pillow with the same fragrance afterwards. During an exam or test, try infusing the same fragrance on your skin or clothes (just don't overdo it, or you might irritate the people writing their exams next to you!)
Furthermore, there is evidence that brief naps (60-90 minutes) in the middle of the day can help with memory consolidation, motor learning, and can also prevent the deterioration of mental and physical performance which tends to happen in a long day. Here is one reference about this:
http://www.ncbi.nlm.nih.gov/pubmed/12819785
6) choose a study or practice environment which is psychologically pleasing. This could include multi-sensory environmental manipulation, including access to healthy foods, smells, comfortable seating, quietness, soothing background noise, etc.
7) if part of the learning task requires repetition, make special effort to infuse the repetition with something imaginative.
8) if part of the practice is for exam preparation, etc. then you could try to mimic the exam environment repeatedly--e.g. by doing mock exams at the same time of day as the scheduled exam, or by doing these practices in the same physical location as the actual exam, if possible.
9) if the practice is for a performance, it can help to record yourself periodically; when you hear or look at your recording you may need to be critical but you should also consciously affirm the aspects of your performance that went well. Self-criticisms should never be in the form of a personal attack (e.g. "I'm stupid!") but should be gentle observations of areas to work on or change.
10) a tutor could be quite helpful, not merely to "teach you" but as a motivational figure to help you practice or study more efficiently or with greater enjoyment (along the lines of a personal trainer for fitness). A friend or study partner could have this type of role, provided the friend does not become a distraction from your work.
Tuesday, April 21, 2009
Good News
Here are a few "good news" websites:
http://www.happynews.com/index.aspx
http://www.goodnewsnetwork.org/
http://www.only-positive-news.com/archives
http://globaldialoguecenter.blogs.com/jbgoodnews/
There is so much bad news in the world today...
Yet, of course, the bad news is accurate: many people are doing many horrible things; whole nations are behaving badly; the whole planet is at risk for irreversible deterioration... It is important and healthy for us to be aware of the truth, even if the truth is difficult to hear.
This reminds me of the way depression can work, particularly chronic depression: the negative, cynical, painful, or pessimistic thoughts associated with depression may represent accurate truths about one's life or about the world.
It can feel frustrating, irritating, and shallow to simply ignore the negative thoughts or negative truths, and focus strictly on "happy thoughts." It can feel like mental manipulation to try to convert a negative observation into a positive one.
I believe that part of the solution is not necessarily to try to negate negative thinking. This would be like refusing to learn about the realities of global hunger, environmental pollution, or about a child being bullied in your neighbourhood, and just simply carrying on with a smile as though everything was fine. This is just denial--things have to be done about hunger, pollution, and bullies.
But I do believe that part of the solution is to be informed about positive news that is going on in the world...this requires very deliberate effort.
Human nature, and the human brain, tends to focus on things that are going wrong. This is a vital safety mechanism...it has kept us safe from predators and other environmental dangers over millions of years of evolution. This tendency shows up in news reporting--headlines are all about disasters, not about moments of sublime beauty or courage or hope. Disaster reporting sells more papers, it grabs our attention more strongly--that's the way our brains are made.
In order to have a healthy and balanced lifestyle we must actively inform ourselves of things that are going right, alongside whatever information comes to us about things that are going wrong. We must do this on a global scale, a local community scale, and on a personal scale (within our own thoughts or minds).
Many anxious negative thoughts represent strong over-estimations of risk (e.g. a fearful airline passenger may feel that the likelihood of crashing is 90%, when in fact the likelihood is 0.0001%); in cases like this an objective "cognitive therapy style" analysis and challenging of thoughts can be therapeutic and reassuring.
Cognitive therapy need not discount negative thoughts. An acknowledgment of a very negative reality may be an honest and frank therapeutic step.
But I think cognitive therapy for depression must allow space for seeking out things that are positive.
I invite you to check out some of the websites above, and seek out more (or better) sources of good news (let me know if you find some). I also invite you to pay attention to examples of "good news" in your community, in your daily life, and in your thinking.
http://www.happynews.com/index.aspx
http://www.goodnewsnetwork.org/
http://www.only-positive-news.com/archives
http://globaldialoguecenter.blogs.com/jbgoodnews/
There is so much bad news in the world today...
Yet, of course, the bad news is accurate: many people are doing many horrible things; whole nations are behaving badly; the whole planet is at risk for irreversible deterioration... It is important and healthy for us to be aware of the truth, even if the truth is difficult to hear.
This reminds me of the way depression can work, particularly chronic depression: the negative, cynical, painful, or pessimistic thoughts associated with depression may represent accurate truths about one's life or about the world.
It can feel frustrating, irritating, and shallow to simply ignore the negative thoughts or negative truths, and focus strictly on "happy thoughts." It can feel like mental manipulation to try to convert a negative observation into a positive one.
I believe that part of the solution is not necessarily to try to negate negative thinking. This would be like refusing to learn about the realities of global hunger, environmental pollution, or about a child being bullied in your neighbourhood, and just simply carrying on with a smile as though everything was fine. This is just denial--things have to be done about hunger, pollution, and bullies.
But I do believe that part of the solution is to be informed about positive news that is going on in the world...this requires very deliberate effort.
Human nature, and the human brain, tends to focus on things that are going wrong. This is a vital safety mechanism...it has kept us safe from predators and other environmental dangers over millions of years of evolution. This tendency shows up in news reporting--headlines are all about disasters, not about moments of sublime beauty or courage or hope. Disaster reporting sells more papers, it grabs our attention more strongly--that's the way our brains are made.
In order to have a healthy and balanced lifestyle we must actively inform ourselves of things that are going right, alongside whatever information comes to us about things that are going wrong. We must do this on a global scale, a local community scale, and on a personal scale (within our own thoughts or minds).
Many anxious negative thoughts represent strong over-estimations of risk (e.g. a fearful airline passenger may feel that the likelihood of crashing is 90%, when in fact the likelihood is 0.0001%); in cases like this an objective "cognitive therapy style" analysis and challenging of thoughts can be therapeutic and reassuring.
Cognitive therapy need not discount negative thoughts. An acknowledgment of a very negative reality may be an honest and frank therapeutic step.
But I think cognitive therapy for depression must allow space for seeking out things that are positive.
I invite you to check out some of the websites above, and seek out more (or better) sources of good news (let me know if you find some). I also invite you to pay attention to examples of "good news" in your community, in your daily life, and in your thinking.
Wednesday, April 15, 2009
Preparing for a psychiatry interview
There are many reasons to see a psychiatrist. There are different types of psychiatric interviews, depending on the situation and on the individuals involved.
A psychiatric interview is a chance to describe your history, examine your problems, review your symptoms in detail, and hopefully to make a plan for things to change.
You may feel reserved about sharing your personal history in detail until you have built up a greater trust in the therapeutic relationship. I think it is important to feel comfortable with your psychiatrist, and to know that you don't have to talk about certain things, or to answer certain questions, unless it is your wish to do so.
There are some elements of a psychiatric history which you can organize or prepare in advance, if you wish, and if these things are relevant to you:
1) charts or chronologies of specific symptoms
-if you have had a history of mood symptoms, it can be informative to prepare a chart showing how your symptoms have changed over time.
-your chart might start literally at your birth, continuing up to the present, with a graph showing how your mood has changed (e.g. showing when your mood has felt good, felt anxious, felt depressed, felt manic, etc.)
-a closer examination of the past few months, or past few years, could allow you to show mood changes in more detail
-underneath the graph of your symptom, you might include significant life events (e.g. losses, changes or problems in school, work, relationships, family, finances, etc.). This allows an examination of the relationship between life events and symptoms
-in another row underneath the graph of your symptoms, you might include any treatments you have attempted (e.g. starting, changing, or stopping any counseling, medications, or self-help)
-these charts could illustrate the long-term pattern of your mood, and illustrate what things might have helped or hindered your problems over the years
-if you have had medication treatments, it can be especially useful to see how your symptoms have changed in association with starting or stopping the medication
Here is an on-line example of a so-called "restrospective life chart":http://www.bipolarnews.org/pdfs/Patient%20Retrospective%20Form%20.pdf I find this particular chart cumbersome and cluttered--I invite you to make your own simple, personalized version of such a chart, with areas on the chart pertinent to your own specific symptoms or treatments.
There are various monthly mood symptom charts you can find on-line. I have included my own version of a monthly mood chart, which you could adapt according to your own symptoms. You can right-click on the chart above, select "copy image", then open your word processor and paste the image onto a new empty word processing file. To use my chart, you could circle the number most representative of how your symptom is on a given day; or make an oval over several numbers at once to show symptoms that have fluctuated during the same day; or you could gradually trace a line showing symptom changes, without circling the numbers, etc. I made my chart in a few minutes using Excel--you could make your own, with different categories relevant to your situation.
2) sometimes writing a narrative essay about your life can be a useful exercise to prepare for a psychiatric interview; however, you may wish to speak out this narrative during therapy sessions, rather than write it down in advance. You may find that you can do both: in the course of therapy, you may find elements of your written narrative to expand upon or emphasize more strongly, other new elements to write about for the first time, and other elements you may wish to retire from the foreground.
Tuesday, April 14, 2009
Interesting mental health journals
Here are a few journals I recommend following. At my university office I enjoy the luxury of full electronic access to these journals, but almost everyone should at least be able to find on-line abstracts (brief summaries) of articles from each journal. Browsing through some of these will give you a general idea of what's going on in research. There might be a few of these journals you will want to follow in more detail; for this I recommend a monthly trip to a local university library.
I may add to or modify this list over time.
I. General Psychiatry Journals:
The American Journal of Psychiatry: http://ajp.psychiatryonline.org/
Archives of General Psychiatry: http://archpsyc.ama-assn.org/
British Journal of Psychiatry: http://bjp.rcpsych.org/
Canadian Journal of Psychiatry: http://publications.cpa-apc.org/browse/sections/0
II. Psychotherapy Journals:
Psychotherapy Theory, Research, Practice, Training: http://www.apa.org/journals/pst/
American Journal of Psychotherapy: http://web.ebscohost.com/ehost/detail?vid=1&hid=104&sid=e3578a6f-d67f-4195-bde8-70686c4c1f0c%40sessionmgr103&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=a9h&jid=ATC
Clinical Psychology and Psychotherapy: http://web.ebscohost.com/ehost/detail?vid=1&hid=104&sid=81922580-de66-4070-9f45-506927e0361c%40sessionmgr108&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=a9h&jid=BUX
British Journal of Psychotherapy: http://www3.interscience.wiley.com/journal/117987371/home
Behavioural and Cognitive Psychotherapy: http://journals.cambridge.org/action/displayJournal?jid=BCP
Sexual and Relationship Therapy: http://www.informaworld.com/smpp/title~content=t713446685~db=all
IV. Psychology Journals:
Journal of Personality and Social Psychology: http://www.apa.org/journals/psp/
Journal of Educational Psychology: http://www.apa.org/journals/edu/
Journal of Consulting and Clinical Psychology: http://www.apa.org/journals/ccp/homepage.html
V. Journals pertaining to specific areas within mental health:
Addiction: http://www3.interscience.wiley.com/journal/117967480/toc?CRETRY=1&SRETRY=0
Eating Disorders: the Journal of Treatment and Prevention: http://www.informaworld.com/smpp/title~content=t713666342~db=all
International Journal of Eating Disorders: http://www3.interscience.wiley.com/journal/34698/home
Schizophrenia Research: http://www.sciencedirect.com/science/journal/09209964
Depression and Anxiety: http://www3.interscience.wiley.com/journal/38924/home
Journal of Personality Disorders: http://www.atypon-link.com/GPI/loi/pedi?cookieSet=1
Sleep: http://www.journalsleep.org/
Archives of Sexual Behavior: http://www.springerlink.com/content/101587/
The Journal of Sexual Medicine: http://www3.interscience.wiley.com/journal/118495964/home
VI. Journals pertaining to general health and medicine:
American Journal of Clinical Nutrition: http://www.ajcn.org/
American Journal of Epidemiology: http://aje.oxfordjournals.org/
Journal of the American Medical Association: http://jama.ama-assn.org/
Archives of Internal Medicine: http://archinte.ama-assn.org/
New England Journal of Medicine: http://content.nejm.org/
Science: http://www.sciencemag.org/ (particularly the medicine & neuroscience sections)
Nature: http://www.nature.com/nature/index.html (particularly the medical research & neuroscience sections)
I may add to or modify this list over time.
I. General Psychiatry Journals:
The American Journal of Psychiatry: http://ajp.psychiatryonline.org/
Archives of General Psychiatry: http://archpsyc.ama-assn.org/
British Journal of Psychiatry: http://bjp.rcpsych.org/
Canadian Journal of Psychiatry: http://publications.cpa-apc.org/browse/sections/0
II. Psychotherapy Journals:
Psychotherapy Theory, Research, Practice, Training: http://www.apa.org/journals/pst/
American Journal of Psychotherapy: http://web.ebscohost.com/ehost/detail?vid=1&hid=104&sid=e3578a6f-d67f-4195-bde8-70686c4c1f0c%40sessionmgr103&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=a9h&jid=ATC
Clinical Psychology and Psychotherapy: http://web.ebscohost.com/ehost/detail?vid=1&hid=104&sid=81922580-de66-4070-9f45-506927e0361c%40sessionmgr108&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=a9h&jid=BUX
British Journal of Psychotherapy: http://www3.interscience.wiley.com/journal/117987371/home
Behavioural and Cognitive Psychotherapy: http://journals.cambridge.org/action/displayJournal?jid=BCP
Sexual and Relationship Therapy: http://www.informaworld.com/smpp/title~content=t713446685~db=all
IV. Psychology Journals:
Journal of Personality and Social Psychology: http://www.apa.org/journals/psp/
Journal of Educational Psychology: http://www.apa.org/journals/edu/
Journal of Consulting and Clinical Psychology: http://www.apa.org/journals/ccp/homepage.html
V. Journals pertaining to specific areas within mental health:
Addiction: http://www3.interscience.wiley.com/journal/117967480/toc?CRETRY=1&SRETRY=0
Eating Disorders: the Journal of Treatment and Prevention: http://www.informaworld.com/smpp/title~content=t713666342~db=all
International Journal of Eating Disorders: http://www3.interscience.wiley.com/journal/34698/home
Schizophrenia Research: http://www.sciencedirect.com/science/journal/09209964
Depression and Anxiety: http://www3.interscience.wiley.com/journal/38924/home
Journal of Personality Disorders: http://www.atypon-link.com/GPI/loi/pedi?cookieSet=1
Sleep: http://www.journalsleep.org/
Archives of Sexual Behavior: http://www.springerlink.com/content/101587/
The Journal of Sexual Medicine: http://www3.interscience.wiley.com/journal/118495964/home
VI. Journals pertaining to general health and medicine:
American Journal of Clinical Nutrition: http://www.ajcn.org/
American Journal of Epidemiology: http://aje.oxfordjournals.org/
Journal of the American Medical Association: http://jama.ama-assn.org/
Archives of Internal Medicine: http://archinte.ama-assn.org/
New England Journal of Medicine: http://content.nejm.org/
Science: http://www.sciencemag.org/ (particularly the medicine & neuroscience sections)
Nature: http://www.nature.com/nature/index.html (particularly the medical research & neuroscience sections)
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