Findings

Out of your mind

Kevin Lewis

March 31, 2013

Less Is Still More: Maintenance of the Very Brief Exposure Effect 1 Year Later

Paul Siegel & Richard Warren
Emotion, forthcoming

Abstract:
This study tested the hypothesis that an immediate effect of exposure to masked phobic stimuli on avoidance of the corresponding feared object would be maintained 1 year later. Fifty-three spider-phobic participants were identified with a questionnaire and a Behavioral Avoidance Test (BAT) with a live tarantula. One week later, they were administered 1 of 3 types of exposure: very brief (25-ms, masked) or clearly visible (125-ms, unmasked) images of spiders, or very brief images of flowers. They engaged in the BAT again immediately thereafter. One year later, they returned for a follow-up BAT. The immediate effect of exposure to very brief spiders on reducing avoidance of the tarantula was still evident 1 year later. Endurance of an effect by masked stimuli of this duration has not been reported before. Potential theoretical implications are discussed.

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Dr. Phil and Psychology Today as Self-Help Treatments of Mental Illness: A Content Analysis of Popular Psychology Programming

Eric Rasmussen & David Ewoldsen
Journal of Health Communication, forthcoming

Abstract:
Many people with a diagnosable mental illness do not receive professional treatment. Instead, they may turn to media mental health professionals for diagnosis and treatment recommendations. This study content analyzed episodes of Dr. Phil and issues of Psychology Today to determine what mental disorders are covered and treatments are recommended, and to determine whether their coverage of mental disorders corresponds to the national prevalence of mental disorders. Both sources provide content about depression more than about any other mental illness. Both also make recommendations for psychotherapy more than they recommend other forms of treatment. The study also found no relation between the proportion of times that mental disorders were discussed and the prevalence of the disorders among American adults. This research helps to lay a foundation for future research addressing the relations among mental disorders, self-treatment, and the media's role in mental health.

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The effectiveness of structural interventions at suicide hotspots: A meta-analysis

Jane Pirkis et al.
International Journal of Epidemiology, forthcoming

Background: Certain sites have gained notoriety as ‘hotspots' for suicide by jumping. Structural interventions (e.g. barriers and safety nets) have been installed at some of these sites. Individual studies examining the effectiveness of these interventions have been underpowered.

Method: We conducted a meta-analysis, pooling data from nine studies.

Results: Following the interventions, there was an 86% reduction in jumping suicides per year at the sites in question (95% CI 79% to 91%). There was a 44% increase in jumping suicides per year at nearby sites (95% CI 15% to 81%), but the net gain was a 28% reduction in all jumping suicides per year in the study cities (95% CI 13% to 40%).

Conclusions: Structural interventions at ‘hotspots' avert suicide at these sites. Some increases in suicide are evident at neighbouring sites, but there is an overall gain in terms of a reduction in all suicides by jumping.

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Facial cues to depressive symptoms and their associated personality attributions

Naomi Jane Scott et al.
Psychiatry Research, forthcoming

Abstract:
Depression is a common mental health disorder, with 12% of the UK population diagnosed at any one time. We assessed whether there are cues to depressive symptoms within the static, non-expressive face, and if other socially-relevant impressions might be made by these cues. Composite "average" face images were created from students scoring high and low on self-report measures of depressive symptoms, capturing potential correlations between facial appearance and symptoms of depression. These were then used in a warping procedure, creating two versions of individual faces, one warped towards the high symptom composite, and the other towards the low. In Experiment 1, we first found observers were able to identify images representing high and low symptom occurrence at levels significantly greater than chance. Secondly, we collected observer impressions of the two versions of each face. The faces reflecting high levels of depressive symptoms were picked as less socially-desirable over a broad range of personality trait estimates compared to low symptom images. In Experiment 2, we replicated the key finding that the static face contains cues to levels of depression symptoms, using composites created from a new database of student photos and depression inventory scores.

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Neuroticism as Distancing: Perceptual Sources of Evidence

Tianwei Liu, et al.
Journal of Personality and Social Psychology, forthcoming

Abstract:
Several theories and self-reported sources of data link individual differences in negative affectivity to avoidance motivation. Chronic avoidance motivation, through repeated practice, may result in a relatively cognitive distance-enhancing dynamic whereby events and stimuli are perceived as further away from the self, even when they are not threatening. Such predictions are novel but follow from cybernetic theories of self-regulation. In 5 studies (total N = 463), relations of this type were investigated. Study 1 presented participants with phrases that were ambiguous and found that trait negative affect predicted phrase interpretation in a distance-enhancing temporal direction. Study 2 replicated this effect across a systematic manipulation of event valence. Study 3 asked individuals to estimate the size of words and found that individuals higher in neuroticism generally perceived words to be smaller than did individuals lower in neuroticism. In Study 4, people high (but not low) in neuroticism perceived words to be shrinking faster than they were growing. In Study 5, greater perceptual distancing, in a font size estimation task, predicted more adverse reactions to negative events in daily life. Although normative effects varied across studies, consistent support for a chronic distancing perspective of individual differences in negative affectivity was found.

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Family Presence during Cardiopulmonary Resuscitation

Patricia Jabre et al.
New England Journal of Medicine, 14 March 2013, Pages 1008-1018

Background: The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial.

Methods: We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with post-traumatic stress disorder (PTSD)-related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims.

Results: In the intervention group, 211 of 266 relatives (79%) witnessed CPR, as compared with 131 of 304 relatives (43%) in the control group. In the intention-to-treat analysis, the frequency of PTSD-related symptoms was significantly higher in the control group than in the intervention group (adjusted odds ratio, 1.7; 95% confidence interval [CI], 1.2 to 2.5; P=0.004) and among family members who did not witness CPR than among those who did (adjusted odds ratio, 1.6; 95% CI, 1.1 to 2.5; P=0.02). Relatives who did not witness CPR had symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medicolegal claims.

Conclusions: Family presence during CPR was associated with positive results on psychological variables and did not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts.

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The Impact of the Developmental Timing of Trauma Exposure on PTSD Symptoms and Psychosocial Functioning Among Older Adults

Christin Ogle, David Rubin & Ilene Siegler
Developmental Psychology, forthcoming

Abstract:
The present study examined the impact of the developmental timing of trauma exposure on posttraumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (N = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas experienced during childhood, adolescence, young adulthood, midlife, or older adulthood. Each of these developmental periods is characterized by age-related changes in cognitive and social processes that may influence psychological adjustment following trauma exposure. Results revealed that older adults who experienced their currently most distressing traumatic event during childhood exhibited more severe symptoms of PTSD and lower subjective happiness compared with older adults who experienced their most distressing trauma after the transition to adulthood. Similar findings emerged for measures of social support and coping ability. The differential effects of childhood compared with later life traumas were not fully explained by differences in cumulative trauma exposure or by differences in the objective and subjective characteristics of the events. Our findings demonstrate the enduring nature of traumatic events encountered early in the life course and underscore the importance of examining the developmental context of trauma exposure in investigations of the long-term consequences of traumatic experiences.

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Mental Health Problems in Teens Investigated by U.S. Child Welfare Agencies

Amy Heneghan et al.
Journal of Adolescent Health, forthcoming

Purpose: To examine prevalence and correlates of five mental health (MH) problems among 12-17.5 year olds investigated by child welfare.

Methods: Data from the National Survey on Child and Adolescent Well-being (NSCAW II) were analyzed to examine depression, anxiety, substance use/abuse, suicidality, and attention deficit hyperactivity disorder (ADHD) as reported by teens and their caregivers. In a sample of 815 adolescents, prevalence for each MH problem and correlates (e.g., age, placement location) were identified using bivariate and multivariable logistic analyses.

Results: After investigation for maltreatment, 42.7% of teens reported at least one MH problem, regardless of placement. Nine percent reported depression, 13.9% reported suicidality, 23% had substance use/abuse, 13.5% reported anxiety, and 18.6% had ADHD. Of 332 teens with any MH problem, 52.1% reported only one problem, 28.3% had two problems, and 19.6% had ≥ three problems. Teens with prior out-of-home placement had odds 2.29 times higher of reporting a MH problem and odds 2.12 times higher of reporting substance use/abuse. Males were significantly less likely to report depression. Older teens were more likely to report substance use/abuse. Black teens were significantly less likely to report suicidality and ADHD and almost half as likely to report anxiety. Teens with a chronic health condition and teens whose caregiver reported depression had more than twice the odds of reporting anxiety.

Conclusions: This study highlights high rates of MH problems in teens of all ages and placement locations and suggests that all teens involved with child welfare should be screened for MH problems, regardless of initial placement status.

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Impact of Racial Macro- and Microaggressions in Black Women's Lives: A Preliminary Analysis

Roxanne Donovan et al.
Journal of Black Psychology, April 2013, Pages 185-196

Abstract:
Most studies on perceived racial discrimination do not differentiate between macroaggressions (i.e., overt, purposeful discrimination) and microaggressions (i.e., subtle, typically unconscious discrimination) or examine gender. This study addresses these gaps by exploring: (a) the prevalence of perceived racial macroaggressions (PRMa) and perceived racial microaggressions (PRMi) in Black women's lives and (b) how PRMa and PRMi influence depressive and anxious symptoms in this group. Participants were 187 undergraduate students who self-identified as Black women. Sixty-three percent of the participants reported experiencing some type of PRMa at least once in a while during the past year, and 96% reported experiencing some type of PRMi at least a few times a year. As hypothesized, PRMa and PRMi significantly predicted depressive symptoms; however, PRMa made a stronger unique contribution. Contrary to hypotheses, PRMa but not PRMi significantly predicted anxious symptoms. Findings suggest that PRMa and PRMi are common occurrences for Black women and are associated with negative mental health outcomes, with PRMa being the less common but more detrimental of the two.

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The Moderating Effects of Skin Color and Ethnic Identity Affirmation on Suicide Risk among Low-SES African American Women

Brea Perry, Danelle Stevens-Watkins & Carrie Oser
Race and Social Problems, March 2013, Pages 1-14

Abstract:
This study examined the influence of concurrent racism and sexism experiences (i.e., gendered racism) on African American women's suicidal ideation and behavior in the context of disadvantaged socioeconomic status. Drawing on a stress process framework, the moderating effects of ethnic identity and skin color were explored using multiple regression analyses. Data were from 204 low-income African American women in the B-WISE (Black Women in a Study of Epidemics) project. Findings suggested that experiencing gendered racism significantly increased these women's risk for suicidal ideation or behavior, though only among women with medium or dark skin color. Also, having strong ethnic identity buffered the harmful effects of gendered racism. The moderating properties of skin color and ethnic identity affirmation likely operate through psychosocial pathways, blocking internalization of negative stereotypes and reducing the level of distress experienced in response to gendered racism.

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Environmental stress, oxytocin receptor gene (OXTR) polymorphism, and mental health following collective stress

Rachel Lucas-Thompson & Alison Holman
Hormones and Behavior, forthcoming

Abstract:
We examined whether the oxytocin receptor gene (OXTR) single nucleotide polymorphism (SNP) rs53576 genotype buffers the combined impact of negative social environments (e.g., interpersonal conflict/constraint) and economic stress on post-traumatic stress (PTS) symptoms and impaired daily functioning following collective stress (September 11th terrorist attacks). Saliva was collected by mail and used to genotype 704 respondents. Participants completed Web-based assessments of pre-9/11 mental health, acute stress 9-23 days after 9/11, the quality of social environments 1 year post-9/11, economic stress 18 months post-9/11, and PTS symptoms and impaired functioning 2 and 3 years post-9/11. Interactions between negative social environments and economic stress were examined separately based on OXTR rs53576 genotype (GG vs. any A allele). For individuals with an A allele, a negative social environment significantly increased PTS symptoms without regard to the level of economic stress experienced. However, for respondents with a GG genotype, negative social environments predicted elevated PTS symptoms only for those also experiencing high economic stress. Gender moderated associations between negative social environments, economic stress, and impaired functioning. The functioning of females was most affected by negative social environments regardless of genotype and economic stress, whereas the functioning of males was differentially susceptible to economic stress depending on OXTR genotype and negative social environments. These findings suggest that it is important to consider the combined impact of gender and ongoing stress in different domains as moderators of genetic vulnerability following collective stress.

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The Genetic Precursors and the Advantageous and Disadvantageous Sequelae of Inhibited Temperament: An Evolutionary Perspective

Patrick Davies et al.
Developmental Psychology, forthcoming

Abstract:
Guided by evolutionary game theory (Korte, Koolhaas, Wingfield, & McEwen, 2005), this study aimed to identify the genetic precursors and the psychosocial sequelae of inhibited temperament in a sociodemographically disadvantaged and racially diverse sample (N = 201) of 2-year-old children who experienced elevated levels of domestic violence. Using a multimethod, prospective design across 3 annual measurement occasions, the authors conducted structural equation modeling analyses indicating that trained observer ratings of inhibited temperament at age 2 were uniquely predicted by polymorphisms in dopamine and serotonin transporter genes. Children's inhibited temperament, in turn, indirectly predicted decreases in their externalizing problems at age 4 through its association with greater behavioral flexibility at age 3. Results highlight the value of integrating evolutionary and developmental conceptualizations in more comprehensively charting the developmental cascades of inhibited temperament.

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Salivary Cortisol Lower in Posttraumatic Stress Disorder

Helané Wahbeh & Barry Oken
Journal of Traumatic Stress, forthcoming

Abstract:
Altered cortisol has been demonstrated to be lower in those with posttraumatic stress disorder (PTSD) in most studies. This cross-sectional study evaluated salivary cortisol at waking and 30 minutes after, and at bedtime in 51 combat veterans with PTSD compared to 20 veterans without PTSD. It also examined the relationship of cortisol to PTSD symptoms using 2 classifications: the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994) and the more recent 4-factor classification proposed for DSM-5. The PTSD group had lower cortisol values than the control group, F(6, 69) = 3.35, p = .006. This significance did not change when adding age, body mass index, smoking, medications affecting cortisol, awakening time, sleep duration, season, depression, perceived stress, service era, combat exposure, and lifetime trauma to the model. Post hoc analyses revealed that the PTSD group had lower area-under-the-curve ground and waking, 30 min, and bedtime values; the cortisol awakening response and area-under-the-curve increase were not different between groups. The 4-factor avoidance PTSD symptom cluster was associated with cortisol, but not the other symptom clusters. This study supports the finding that cortisol is lower in people with PTSD.

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Mortality, ADHD, and Psychosocial Adversity in Adults With Childhood ADHD: A Prospective Study

William Barbaresi et al.
Pediatrics, forthcoming

Objective: We examined long-term outcomes of attention-deficit/hyperactivity disorder (ADHD) in a population-based sample of childhood ADHD cases and controls, prospectively assessed as adults.

Methods: Adults with childhood ADHD and non-ADHD controls from the same birth cohort (N = 5718) were invited to participate in a prospective outcome study. Vital status was determined for birth cohort members. Standardized mortality ratios (SMRs) were constructed to compare overall and cause-specific mortality between childhood ADHD cases and controls. Incarceration status was determined for childhood ADHD cases. A standardized neuropsychiatric interview was administered.

Results: Vital status for 367 childhood ADHD cases was determined: 7 (1.9%) were deceased, and 10 (2.7%) were currently incarcerated. The SMR for overall survival of childhood ADHD cases versus controls was 1.88 (95% confidence interval [CI], 0.83-4.26; P = .13) and for accidents only was 1.70 (95% CI, 0.49-5.97; P = .41). However, the cause-specific mortality for suicide only was significantly higher among ADHD cases (SMR, 4.83; 95% CI, 1.14-20.46; P = .032). Among the childhood ADHD cases participating in the prospective assessment (N = 232; mean age, 27.0 years), ADHD persisted into adulthood for 29.3% (95% CI, 23.5-35.2). Participating childhood ADHD cases were more likely than controls (N = 335; mean age, 28.6 years) to have ≥1 other psychiatric disorder (56.9% vs 34.9%; odds ratio, 2.6; 95% CI, 1.8-3.8; P < .01).

Conclusions: Childhood ADHD is a chronic health problem, with significant risk for mortality, persistence of ADHD, and long-term morbidity in adulthood.

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Growing Old but Not Growing Apart: Twin Similarity in the Latter Half of the Lifespan

Matt McGue & Kaare Christensen
Behavior Genetics, January 2013, Pages 1-12

Abstract:
While a substantial amount of behavioral genetic research has helped to characterize developmental trends in twin similarity in early life, relatively little is known about changes in twin similarity with age in adulthood. We investigated age moderation of twin similarity for a composite measure of cognitive ability, depression symptomatology and hand grip strength in a cross-sectional sample of 2,332 like-sex pairs of Danish twins age 46-96 years. All three outcomes were strongly correlated with age, indicating that the three phenotypes analyzed are not developmentally static. Nonetheless, in moderated regression analysis we found no evidence of declining twin similarity for any of the three outcomes in either zygosity group. Moreover, biometric analysis of the twin data revealed minimal differences in heritability estimates across the age range sampled. While small sample size limits our ability to draw firm conclusions at very advanced ages, these findings call into question the hypothesis that the cumulative impact of life experiences diminishes twin similarity at least through age 80. We hypothesize that twins are able to maintain similarity over extended periods of time because in part they are able to construct similar environments that reinforce that similarity.

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Comprehensive Phenotype/Genotype Analyses of the Norepinephrine Transporter Gene (SLC6A2) in ADHD: Relation to Maternal Smoking during Pregnancy

Geeta Thakur et al.
PLoS ONE, November 2012

Objective: Despite strong pharmacological evidence implicating the norepinephrine transporter in ADHD, genetic studies have yielded largely insignificant results. We tested the association between 30 tag SNPs within the SLC6A2 gene and ADHD, with stratification based on maternal smoking during pregnancy, an environmental factor strongly associated with ADHD.

Methods: Children (6-12 years old) diagnosed with ADHD according to DSM-IV criteria were comprehensively evaluated with regard to several behavioral and cognitive dimensions of ADHD as well as response to a fixed dose of methylphenidate (MPH) using a double-blind placebo controlled crossover trial. Family-based association tests (FBAT), including categorical and quantitative trait analyses, were conducted in 377 nuclear families.

Results: A highly significant association was observed with rs36021 (and linked SNPs) in the group where mothers smoked during pregnancy. Association was noted with categorical DSM-IV ADHD diagnosis (Z = 3.74, P = 0.0002), behavioral assessments by parents (CBCL, P = 0.00008), as well as restless-impulsive subscale scores on Conners'-teachers (P = 0.006) and parents (P = 0.006). In this subgroup, significant association was also observed with cognitive deficits, more specifically sustained attention, spatial working memory, planning, and response inhibition. The risk allele was associated with significant improvement of behavior as measured by research staff (Z = 3.28, P = 0.001), parents (Z = 2.62, P = 0.009), as well as evaluation in the simulated academic environment (Z = 3.58, P = 0.0003).

Conclusions: By using maternal smoking during pregnancy to index a putatively more homogeneous group of ADHD, highly significant associations were observed between tag SNPs within SLC6A2 and ADHD diagnosis, behavioral and cognitive measures relevant to ADHD and response to MPH. This comprehensive phenotype/genotype analysis may help to further understand this complex disorder and improve its treatment.


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