Kevin Lewis

December 22, 2012

The Injuries of Reading: Jesse Pomeroy and the Dire Effects of Dime Novels

Dawn Keetley
Journal of American Studies, forthcoming

In December 1874, at the age of fifteen, Jesse Pomeroy became the youngest person in Massachusetts ever to be sentenced to death. He had, when he was twelve, tortured seven children in his South Boston neighborhood, subsequently mutilating and killing two others. All Pomeroy said in explanation was that he "couldn't help it." This essay argues that an important cause of Pomeroy's affectless violence was one held by many of his contemporaries but dismissed by later cultural historians: his voracious reading of dime novel westerns. Central to cheap western literature was the formulaic scene of torture practiced by Indians and white renegades. Pomeroy's crimes, as I will describe, strikingly repeated these accounts, and they further disclose his dangerous identification with the unambiguously evil renegade Simon Girty. Moreover, the logic of torture in dime novel westerns - the fact that the torture is promised but never delivered - maps perfectly onto what have been called the "nonfulfilled experiences" central to the fantasies of serial killers. Just as with some horrific crimes of our own era, it seemed as if the mass media - specifically the mass production of repetitive violent images and plots - had indeed played a role in a boy's compulsive violence.


Factors Associated With Temporal and Spatial Patterns in Suicide Rates Across U.S. States, 1976-2000

Julie Phillips
Demography, forthcoming

Using pooled cross-sectional time-series data for the 50 U.S. states over a 25-year period, this article examines how well four conceptual groups of social correlates - demographic, economic, social, and cultural factors - are associated with the 1976-2000 patterns in overall suicide rates and suicide by firearms and other means. Unlike past research that typically considers only one dimension, this analysis differentiates between spatial and temporal variation in suicide rates to determine whether and how social correlates operate differently in these two contexts. Results indicate that suicide rates correspond closely to social correlates. Within U.S. states, lower overall suicide rates between 1976 and 2000 were associated with demographic change (e.g., larger numbers of foreign-born) as well as with fewer numbers of Episcopalians. Across U.S. states, variation in overall suicide rates over the period was related to demographic (percentage male), economic (per capita income), social (percentage divorced), and cultural (alcohol consumption and gun ownership) factors. However, findings differ importantly by type of suicide, and across time and space. Reasons for these distinct patterns are discussed.


Appetitive Aggression as a Resilience Factor against Trauma Disorders: Appetitive Aggression and PTSD in German World War II Veterans

Roland Weierstall et al.
PLoS ONE, December 2012

Background: Repeated exposure to traumatic stressors such as combat results in chronic symptoms of PTSD. However, previous findings suggest that former soldiers who report combat-related aggression to be appetitive are more resilient to develop PTSD. Appetitive Aggression should therefore prevent widespread mental suffering in perpetrators of severe atrocities even after decades.

Methods and Findings: To test the long-term relationship between trauma-related illness and attraction to aggression, we surveyed a sample of 51 German male World-War II veterans (age: M = 86.7, SD = 2.8). War-related appetitive aggression was assessed with the Appetitive Aggression Scale (AAS). Current- and lifetime PTSD symptoms were assessed with the PSS-I. In a linear regression analysis accounting for 31% of the variance we found that veterans that score higher on the AAS show lower PSS-I symptom severity scores across their whole post-war lifetime (β = - .31, p = .014). The effect size and power were sufficient (f2 = 0.51, (1-β) = .99). The same was true for current PTSD (β = - .27, p = .030).

Conclusions: Appetitive Aggression appears to be a resilience factor for negative long-term effects of combat experiences in perpetrators of violence. This result has practical relevance for preventing trauma-related mental suffering in Peace Corps and for designing adequate homecoming reception for veterans.


Blunted neural response to rewards prospectively predicts depression in adolescent girls

Jennifer Bress et al.
Psychophysiology, January 2013, Pages 74-81

The prevalence of depression increases substantially during adolescence. Several predictors of major depressive disorder have been established, but their predictive power is limited. In the current study, the feedback negativity (FN), an event-related potential component elicited by feedback indicating monetary gain versus loss, was recorded in 68 never-depressed adolescent girls. Over the following 2 years, 24% of participants developed a major depressive episode (MDE); illness onset was predicted by blunted FN at initial evaluation. Lower FN amplitude predicted more depressive symptoms during the follow-up period, even after controlling for neuroticism and depressive symptoms at baseline. This is the first prospective study to demonstrate a link between a neural measure of reward sensitivity and the first onset of an MDE. The current results suggest that low reward sensitivity may be an important factor in the development of depression.


The Long-Term Consequences of Military Deployment: A 5-Year Cohort Study of United Kingdom Reservists Deployed to Iraq in 2003

Samuel Harvey et al.
American Journal of Epidemiology, 15 December 2012, Pages 1177-1184

Reserve and National Guard forces have been mobilized to an unprecedented degree in recent overseas conflicts. There is concern that rates of psychological problems may continue to rise for many years after deployment. The authors conducted a cohort study of 552 United Kingdom Reservists who deployed to Iraq in 2003 and 391 nondeployed Reservists. Measures of mental health and social functioning were collected a mean of 16 months and 4.8 years after return from possible deployment. At the first follow-up, deployment was associated with increased common mental disorder, post-traumatic stress disorder (PTSD), and poor general health. By the second follow-up, those who had deployed were no longer at increased risk for common mental disorder or poor general health and had good levels of social functioning. However, those who deployed continued to have over twice the odds of PTSD (odds ratio = 2.42, 95% confidence interval: 1.04, 5.62) and were more likely to report actual or serious consideration of separation from their partner. In conclusion, the authors found that the majority of mental health and social problems following deployment are transient. However, Reservists who deployed in the Iraq War remain at increased risk of PTSD and relationship problems 5 years after their tour of duty.


Exercise caution: Over-exercise is associated with suicidality among individuals with disordered eating

April Smith et al.
Psychiatry Research, forthcoming

We conducted four studies to examine the relationship between over-exercise and suicidality. Study 1 investigated whether over-exercise predicted suicidal behavior after controlling for other eating disorder behaviors in a patient sample of 204 women (144 with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Bulimia Nervosa [BN]). Study 2 tested the prospective association between over-exercise and acquired capability for suicide (ACS) in a sample of 171 college students followed for 3-4 weeks. Study 3 investigated whether pain insensitivity accounted for the relationship between over-exercise and ACS in a new sample of 467 college students. Study 4 tested whether ACS accounted for the relationship between over-exercise and suicidal behavior in a sample of 512 college students. In Study 1, after controlling for key covariates, over-exercise was the only disordered eating variable that maintained a significant relationship with suicidal behavior. In Study 2, Time 1 over-exercise was the only disordered eating behavior that was associated with Time 2 ACS. In Study 3, pain insensitivity accounted for the relationship between over-exercise and ACS. In Study 4, ACS accounted for the relationship between over-exercise and suicidal behavior. Over-exercise appears to be associated with suicidal behavior, an association accounted for by pain insensitivity and the acquired capability for suicide; notably, this association was found across a series of four studies with different populations.


The Mediating Effect of Daily Stress on the Sexual Arousal Function of Women With a History of Childhood Sexual Abuse

Gena Zollman, Alessandra Rellini & Danielle Desrocher
Journal of Sex & Marital Therapy, Winter 2013, Pages 176-192

Psychopathologies such as posttraumatic stress disorder are often proposed as mediators of the sexual arousal dysfunction experienced by women with a history of childhood maltreatment. However, posttraumatic stress disorder symptoms are only part of the difficulties experienced by these women. Other factors to consider include negative affectivity and perceived daily stress. To assess the mediating role of posttraumatic stress disorder symptoms, negative affectivity, and perceived daily stress, we collected data from 62 women with and without a history of childhood maltreatment (sexual, physical and emotional abuse). A comprehensive assessment of sexual arousal functioning and sexual responses was obtained using self-reported measures and psychophysiological measures of vaginal engorgement and subjective sexual arousal during exposure to sexual visual stimuli. The model assessed the simultaneous mediating effect of posttraumatic stress disorder symptoms, negative affectivity and perceived daily stress on the relation between childhood maltreatment and sexual variables. Daily stress, showed a significant and stronger mediation effect on sexual arousal functioning as compared to posttraumatic stress disorder and negative affectivity. These findings suggest that daily stress may be an important mechanism to consider when treating sexual arousal functioning in women who have a history of childhood maltreatment.


Exposure to Interpersonal Violence and Its Associations With Psychiatric Morbidity in a U.S. National Sample: A Gender Comparison

Katherine Iverson et al.
Psychology of Violence, forthcoming

Objectives: We examine gender differences in population rates of various types of interpersonal violence in a U.S. national sample and investigate gender as a moderator of the associations between interpersonal violence and lifetime mental disorders and suicide attempts.

Methods: Data were drawn from the National Comorbidity Survey-Replication study; 5,692 women and men completed interviews assessing lifetime exposure to nine types of interpersonal violence, Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) mental health diagnoses, and suicide attempts.

Results: Approximately 46% of women and 42% of men reported one or more types of interpersonal violence. Women were more likely to experience kidnapping, physical assault by an intimate partner, rape, sexual assault, and stalking, whereas men were more likely to experience mugging or physical assault by someone other than parents or an intimate partner. Interpersonal violence was associated with risk for many mental disorders and attempted suicide. Although women were at higher risk for several forms of interpersonal violence, the impact of interpersonal violence on mental health outcomes did not vary by gender.

Conclusions: It is clearly important to identify and provide mental health treatment to women after interpersonal violence exposure. Findings also underscore the need for prevention and intervention efforts for women and men, including routine screening for interpersonal violence by health care providers and appropriate treatment to address mental health conditions.


Panic disorder among African Americans, Caribbean blacks and non-Hispanic whites

Debra Siegel Levine et al.
Social Psychiatry And Psychiatric Epidemiology, forthcoming

Introduction: This study investigated co-morbidities, level of disability, service utilization and demographic correlates of panic disorder (PD) among African Americans, Caribbean blacks and non-Hispanic white Americans.

Methods: Data are from the National Survey of American Life (NSAL) and the National Comorbidity Survey-Replication (NCS-R).

Results: Non-Hispanic whites are the most likely to develop PD across the lifespan compared to the black subgroups. Caribbean blacks were found to experience higher levels of functional impairment. There were no gender differences found in prevalence of PD in Caribbean blacks, indicating that existing knowledge about who is at risk for developing PD (generally more prevalent in women) may not be true among this subpopulation. Furthermore, Caribbean blacks with PD were least likely to use mental health services compared to African Americans and non-Hispanic whites.

Conclusion: This study demonstrates that PD may affect black ethnic subgroups differently, which has important implications for understanding the nature and etiology of the disorder.


Acupoint stimulation in treating psychological disorders: Evidence of efficacy

David Feinstein
Review of General Psychology, December 2012, Pages 364-380

Energy psychology is a clinical and self-help modality that combines verbal and physical procedures for effecting therapeutic change. While utilizing established clinical methods such as exposure and cognitive restructuring, the approach also incorporates concepts and techniques from non-Western healing systems. Its most frequently utilized protocols combine the stimulation of acupuncture points (by tapping on, holding, or massaging them) with the mental activation of a targeted psychological issue. Energy psychology has been controversial, in part due to its reliance on explanatory mechanisms that are outside of conventional clinical frameworks and in part because of claims by its early proponents - without adequate research support - of extraordinary speed and power in attaining positive clinical outcomes. This paper revisits some of the field's early claims, as well as current practices, and assesses them in the context of existing evidence. A literature search identified 51 peer-reviewed papers that report or investigate clinical outcomes following the tapping of acupuncture points to address psychological issues. The 18 randomized controlled trials in this sample were critically evaluated for design quality, leading to the conclusion that they consistently demonstrated strong effect sizes and other positive statistical results that far exceed chance after relatively few treatment sessions. Criteria for evidence-based treatments proposed by Division 12 of the American Psychological Association were also applied and found to be met for a number of anxiety-based conditions, including PTSD. Neurological mechanisms that may be involved in these surprisingly strong findings are also considered.


Dysregulated relationship of inflammation and oxidative stress in major depression

B. Rawdin et al.
Brain, Behavior, and Immunity, forthcoming

Chronic inflammation and oxidative stress have been implicated in the pathophysiology of Major Depressive Disorder (MDD), as well as in a number of chronic medical conditions. The aim of this study was to examine the relationship between peripheral inflammatory and oxidative stress markers in un-medicated subjects with MDD compared to non-depressed healthy controls and compared to subjects with MDD after antidepressant treatment. We examined the relationships between IL-6, IL-10, and the IL-6/IL-10 inflammatory ratio vs. F2-isoprostanes (F2-IsoP), a marker of oxidative stress, in un-medicated MDD patients (n = 20) before and after 8 weeks of open-label sertraline treatment (n = 17), compared to healthy non-depressed controls (n = 20). Among the un-medicated MDD subjects, F2-IsoP concentrations were positively correlated with IL-6 concentrations (p < 0.05) and were negatively correlated with IL-10 concentrations (p < 0.01). Accordingly, F2-IsoP concentrations were positively correlated with the ratio of IL-6/IL-10 (p < 0.01). In contrast, in the control group, there were no significant correlations between F2-IsoPs and either cytokine or their ratio. After MDD subjects were treated with sertraline for 8 weeks, F2-IsoPs were no longer significantly correlated with IL-6, IL-10 or the IL-6/IL-10 ratio. These data suggest oxidative stress and inflammatory processes are positively associated in untreated MDD. Our findings are consistent with the hypothesis that the homeostatic buffering mechanisms regulating oxidation and inflammation in healthy individuals become dysregulated in untreated MDD, and may be improved with antidepressant treatment. These findings may help explain the increased risk of comorbid medical illnesses in MDD.


Mortality and Its Determinants in People With Psychotic Disorder

Jaana Suvisaari et al.
Psychosomatic Medicine, forthcoming

Objective: We investigated mortality and its determinants in people with psychotic disorder.

Methods: A nationally representative two-stage cluster sample of 8028 persons aged 30 years or older from Finland was selected for a comprehensive health survey conducted from 2000 to 2001. Participants were screened for psychotic disorder, and screen-positive persons were invited for a Structured Clinical Interview for DSM-IV. The diagnostic assessment of DSM-IV psychotic disorders was based on the Structured Clinical Interview for DSM-IV, case records from mental health treatments, or both. Mortality was followed up until September 2009 and analyzed using Cox proportional hazards model.

Results: People with schizophrenia (hazard ratio [HR] = 3.03; 95% confidence interval [CI] = 1.93-4.77) and other nonaffective psychoses (HR = 1.84; 95% CI = 1.17-2.91) had elevated mortality risk, whereas people with affective psychoses did not (HR = 0.61; 95% CI = 0.24-1.55). Antipsychotic medication use was associated with increased mortality (HR = 2.34; 95% CI = 1.86-2.96). There was an interaction between antipsychotic medication use and the presence of a psychotic disorder: antipsychotic medication use was only associated with elevated mortality in persons who were using antipsychotics and did not have primary psychotic disorder. In persons with psychotic disorder, mortality was predicted by smoking and Type 2 diabetes at baseline survey.

Conclusions: Schizophrenia and nonaffective psychoses are associated with increased mortality risk, whereas affective psychoses are not. Antipsychotic medication use increases mortality risk in older people without primary psychotic disorder, but not in individuals with schizophrenia. Smoking and Type 2 diabetes are important predictors of elevated mortality risk in persons with psychotic disorder.


The long-lasting impact of adolescents' deviant friends on suicidality: A 3-year follow-up perspective

Erin Winterrowd & Silvia Sara Canetto
Social Psychiatry And Psychiatric Epidemiology, forthcoming

Background: During adolescence, friends are increasingly important for support and values. Do friends also have a long-term impact on suicidality? This study explored the role of friendship problems (e.g., social isolation) and deviant friends during late adolescence on suicidal ideation and behavior 3 years later.

Method: Participants were 295 community adolescents (59 % Mexican-American; 41 % European-American) from the United States. Information about their suicidal ideation and behavior, depression, friendship problems, and deviant friends was collected at baseline and at a 3-year follow-up.

Results: Having deviant friends was a better predictor of suicidality than having friendship problems, with variability by sex and ethnicity. Having deviant friends predicted suicidal ideation among Mexican-American adolescents. Having friends who were disconnected from school was a risk factor for suicidal ideation among European-American adolescents but a protective factor for suicidal behavior among Mexican-American adolescents, especially boys. Depression played more of a mediating role between friendship factors and suicidality for European-American than for Mexican-American adolescents.

Conclusions: This study's findings suggest an influence of adolescents' deviant friends on suicidality 3 years later. They also call for the cultural and gender grounding of suicide theory, research and prevention.


Developmental pathways to amygdala-prefrontal function and internalizing symptoms in adolescence

Cory Burghy et al.
Nature Neuroscience, December 2012, Pages 1736-1741

Early life stress (ELS) and function of the hypothalamic-pituitary-adrenal axis predict later psychopathology. Animal studies and cross-sectional human studies suggest that this process might operate through amygdala-ventromedial prefrontal cortex (vmPFC) circuitry implicated in the regulation of emotion. Here we prospectively investigated the roles of ELS and childhood basal cortisol amounts in the development of adolescent resting-state functional connectivity (rs-FC), assessed by functional connectivity magnetic resonance imaging (fcMRI), in the amygdala-PFC circuit. In females only, greater ELS predicted increased childhood cortisol levels, which predicted decreased amygdala-vmPFC rs-FC 14 years later. For females, adolescent amygdala-vmPFC functional connectivity was inversely correlated with concurrent anxiety symptoms but positively associated with depressive symptoms, suggesting differing pathways from childhood cortisol levels function through adolescent amygdala-vmPFC functional connectivity to anxiety and depression. These data highlight that, for females, the effects of ELS and early HPA-axis function may be detected much later in the intrinsic processing of emotion-related brain circuits.


Temporal dynamics of emotional responding: Amygdala recovery predicts emotional traits

Brianna Schuyler et al.
Social Cognitive and Affective Neuroscience, forthcoming

An individual's affective style is influenced by many things, including the manner in which an individual responds to an emotional challenge. Emotional response is composed of a number of factors, two of which are the initial reactivity to an emotional stimulus, and the subsequent recovery once the stimulus terminates or ceases to be relevant. However, most neuroimaging studies examining emotional processing in humans focus on the magnitude of initial reactivity to a stimulus rather than the prolonged response. In this study, we use functional magnetic resonance imaging (fMRI) to study the time course of amygdala activity in healthy adults in response to presentation of negative images. We split the amygdala time course into an initial reactivity period and a recovery period beginning after the offset of the stimulus. We find that initial reactivity in the amygdala does not predict trait measures of affective style. Conversely, amygdala recovery shows predictive power such that slower amygdala recovery from negative images predicts greater trait neuroticism, in addition to lower levels of likability of a set of social stimuli (neutral faces). These data underscore the importance of taking into account temporal dynamics when studying affective processing using neuroimaging.


Recent criminal offending and suicide attempts: A national sample

Thomas Bradley Cook
Social Psychiatry And Psychiatric Epidemiology, forthcoming

Purpose: Few studies have assessed the risk of suicide and suicidal behavior among the community-residing population with recent criminal justice involvement despite evidence of high rates of suicide in jails and prisons. This study assessed the association between recent arrest history and a suicide attempt in the previous year including multiple arrests and specific offense categories using a national representative sample of adults.

Methods: Data were derived from 2 years of the National Survey on Drug Use and Health (2008 and 2010), a nationally representative cross-sectional survey of non-institutionalized US adults. Suicide attempts in the previous year based on self-report were assessed in relation to recent arrest history while accounting for socio-demographic factors, mental and physical health status and substance use.

Results: Suicide attempts in the previous year are relatively common among those with recent arrests (2.3 %) compared to the general US population (0.4 %), with much higher prevalence among those with multiple recent arrests or charges (4.5 %). The prevalence of recent suicide attempts among those with multiple recent arrests was highest among adults aged 25-34 (5.7 %), with similar risks between men and women, and across racial and ethnic subgroups. There was no association between arrests prior to the most recent year and recent suicide attempts.

Conclusions: Suicide attempts are common among the non-institutionalized population of US adults with recent criminal justice involvement. Suicide prevention efforts in the criminal justice system should extend to clients who remain in the community both during and immediately following periods of court-processing. Future research is needed to better identify case and client characteristics indicating the highest suicide risk.


Mom - It Helps When You're Right Here! Attenuation of Neural Stress Markers in Anxious Youths Whose Caregivers Are Present during fMRI

Olivia Conner et al.
PLoS ONE, December 2012

Close proximity to an attachment figure, such as a caregiver, has been shown to attenuate threat-related activity in limbic regions such as the hypothalamus in healthy individuals. We hypothesized that such features might be similarly attenuated by proximity during a potentially stressful situation in a clinically anxious population of youths. Confirmation of this hypothesis could support the role of attachment figures in the management of anxiety among children and adolescents. Three groups were analyzed: anxious children and adolescents who requested that their caregiver accompany them in the scanner room, anxious children and adolescents without their caregiver in the scanner room and healthy controls (each of N = 10). The groups were matched for age and, among the two anxious groups, for diagnosis (mean age 9.5). The children and adolescents were exposed to physical threat words during an fMRI assessment. Results indicate that activity in the hypothalamus, ventromedial, and ventrolateral prefrontal cortex were significantly reduced in anxious children and adolescents who requested that their caregiver accompany them in the scanner room compared to those without their caregiver in the scanner room. Mean activity in these regions in anxious children and adolescents with their caregiver in the scanner room was comparable to that of healthy controls. These data suggest links between social contact and neural mechanisms of emotional reactivity; specifically, presence of caregivers moderates the increase in anxiety seen with stressful stimuli. Capitalizing on the ability of anxious youths to manifest low levels of anxiety-like information processing in the presence of a caregiver could help in modeling adaptive function in behavioral treatments.


Allele-specific FKBP5 DNA demethylation mediates gene-childhood trauma interactions

Torsten Klengel et al.
Nature Neuroscience, January 2013, Pages 33-41

Although the fact that genetic predisposition and environmental exposures interact to shape development and function of the human brain and, ultimately, the risk of psychiatric disorders has drawn wide interest, the corresponding molecular mechanisms have not yet been elucidated. We found that a functional polymorphism altering chromatin interaction between the transcription start site and long-range enhancers in the FK506 binding protein 5 (FKBP5) gene, an important regulator of the stress hormone system, increased the risk of developing stress-related psychiatric disorders in adulthood by allele-specific, childhood trauma-dependent DNA demethylation in functional glucocorticoid response elements of FKBP5. This demethylation was linked to increased stress-dependent gene transcription followed by a long-term dysregulation of the stress hormone system and a global effect on the function of immune cells and brain areas associated with stress regulation. This identification of molecular mechanisms of genotype-directed long-term environmental reactivity will be useful for designing more effective treatment strategies for stress-related disorders.

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