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Tag: Psychology and Psychiatry

  • Adding antipsychotic med to antidepressant may help older adults with treatment-resistant depression

    Adding antipsychotic med to antidepressant may help older adults with treatment-resistant depression

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    BYLINE: Jim Dryden

    Newswise — For older adults with clinical depression that has not responded to standard treatments, adding the drug aripiprazole (brand name Abilify) to an antidepressant they’re already taking is more effective than switching from one antidepressant to another, according to a new multicenter study led by Washington University School of Medicine in St. Louis.

    Aripiprazole originally was approved by the FDA in 2002 as a treatment for schizophrenia but also has been used in lower doses as an add-on treatment for clinical depression in younger patients who do not respond to antidepressants alone.

    The new findings are published March 3 in The New England Journal of Medicine and are to be presented that same day by Eric J. Lenze, MD — principal investigator and head of the Department of Psychiatry at Washington University — and colleagues at the annual meeting of the American Association for Geriatric Psychiatry in New Orleans.

    Many people with clinical depression don’t respond to medications used to treat the condition. Consequently, some doctors switch such patients to different antidepressants in the pursuit of finding one that works, while other physicians may prescribe another class of drugs to see if a combination of medications helps.

    Both strategies have been recommended by experts as options for older adults with treatment-resistant depression. However, the new study was designed to help determine which strategy is most effective. Augmenting an antidepressant with aripiprazole helped 30% of patients with treatment-resistant depression, compared to only 20% who were switched to another solo antidepressant, results of the study show.

    “Often, unless a patient responds to the first treatment prescribed for depression, physicians follow a pattern in which they try one treatment after another until they land on an effective medication,” said Lenze, the Wallace and Lucille Renard Professor and the study’s corresponding author. “It would be beneficial to have an evidence-based strategy we can rely on to help patients feel better as quickly as possible. We found that adding aripiprazole led to higher rates of depression remission and greater improvements in psychological well-being — which means how positive and satisfied patients felt — and this is good news. However, even that approach helped only about 30% of people in the study with treatment-resistant depression, underscoring the need to find and develop more effective treatments that can help more people.”

    Treatment-resistant depression is no more or less common in older people than younger people, but because it seems to accelerate cognitive decline, identifying more effective ways to treat it is very important.

    Lenze, along with colleagues at Columbia University, UCLA, the University of Pittsburgh and the University of Toronto, studied 742 people, ages 60 and older, with treatment-resistant depression, meaning their depression had not responded to at least two different antidepressant medications.

    The researchers evaluated strategies commonly used in clinical practice to help alleviate treatment-resistant depression in older patients and designed the study to have two distinct phases. In the first phase, 619 patients, each of whom was taking an antidepressant such as Prozac, Lexapro or Zoloft, were randomly divided into three groups. In the first group, patients remained on whatever antidepressant drug each already was taking but also received the drug aripiprazole (Abilify). A second group also continued taking antidepressants but added bupropion (brand names Wellbutrin or Zyban), and a third group tapered off of the antidepressant each had been taking and switched to bupropion entirely.

    Over the course of 10 weeks, the participants received biweekly phone calls or in-person visits with study clinicians. At these visits, the medications were adjusted according to the individual patient’s response and side effects. The researchers found that the group that experienced the best overall outcomes was the one in which patients continued with their original antidepressants but added aripiprazole.

    The researchers also anticipated that some people in the study wouldn’t respond to the various treatments, so they added a second phase that included 248 participants. In this phase, patients taking antidepressants such as Prozac, Lexapro and Zoloft were treated with lithium or nortriptyline — medications that were widely used before those other, newer antidepressants were approved more than two decades ago. Rates of alleviating depression in the study’s second phase were low, about 15%. And there was no clear winner when augmentation with lithium was compared with switching to nortriptyline.

    “Those older drugs also are a bit more complicated to use than newer treatments,” Lenze explained. “Lithium, for example, requires blood testing to ensure its safety, and it’s recommended that patients taking nortriptyline receive electrocardiograms periodically to monitor the heart’s electrical activity. Since neither lithium nor nortriptyline were promising against treatment-resistant depression in older adults, those medications are unlikely to be helpful in most cases.”

    But even the best treatment strategy — adding aripiprazole to an antidepressant — was not markedly successful for many older patients with treatment-resistant depression.

    “This really highlights a continuing problem in our field,” said senior author Jordan F. Karp, MD, professor and chair of the Department of Psychiatry at the University of Arizona College of Medicine – Tuscon. “Any given treatment is likely to help only a subset of people, and ideally, we would like to know, in advance, who is most likely to be helped, but we still don’t know how to determine that.”

    Lenze emphasized that overall, antidepressants are highly helpful for the majority of people suffering from clinical depression. At least half of all people with depression feel much better after they begin taking the first medication they try. And almost half of the remainder not helped by a first drug improve when switched to a second drug, But that leaves a sizeable group with clinical depression that does not respond to two treatments.

    The problem is particularly difficult in older adults, many of whom already are taking several medications for other conditions such as high blood pressure, cardiac issues or diabetes,” Lenze said. “So switching to new antidepressants every few weeks or adding other psychiatric drugs can be complicated. In addition, because depression and anxiety in older adults may accelerate cognitive decline, there’s an urgency to find more effective treatment strategies.

    “There definitely is something that makes depression harder to treat in this population, a population that’s only going to keep getting larger as our society gets older,” he added.

    Lenze EJ, et al. Trial of antidepressant augmentation vs. switching in treatment-resistant geriatric depression. The New England Journal of Medicine, March 3, 2023.

    The study was funded by a grant from the Patient-Centered Outcomes Research Institute (PCORI), grant TRD-1511-33321. No in-kind support was received from pharmaceutical companies. Other funding was provided by the Taylor Family Institute for Innovative Psychiatric Research at Washington University School of Medicine. Other support came from the National Center for Advancing Translational Sciences and the National Institute of Mental Health of the National Institutes of Health (NIH). Grant numbers: 5RO1 MH114980, K24 AT009198, R01 MH114981. Additional funding provided by the Labatt Family Chair in Biology of Depression in Late-Life Adults at the University of Toronto.

    About Washington University School of Medicine

    WashU Medicine is a global leader in academic medicine, including biomedical research, patient care and educational programs with 2,800 faculty. Its National Institutes of Health (NIH) research funding portfolio is the third largest among U.S. medical schools, has grown 52% in the last six years, and, together with institutional investment, WashU Medicine commits well over $1 billion annually to basic and clinical research innovation and training. Its faculty practice is consistently within the top five in the country, with more than 1,800 faculty physicians practicing at 65 locations and who are also the medical staffs of Barnes-Jewish and St. Louis Children’s hospitals of BJC HealthCare. WashU Medicine has a storied history in MD/PhD training, recently dedicated $100 million to scholarships and curriculum renewal for its medical students, and is home to top-notch training programs in every medical subspecialty as well as physical therapy, occupational therapy, and audiology and communications sciences.

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    Washington University in St. Louis

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  • Newswise Live Event for March 15: What can we expect from AI and Chatbots in the next few years?

    Newswise Live Event for March 15: What can we expect from AI and Chatbots in the next few years?

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    What: What can we expect from AI and Chatbots in the next few years? A Newswise Live Event

    When: Wednesday, March 15, 2023, 1 PM to 2 PM EST

    Who: Expert Panelists include:

    • Sercan Ozcan, Reader (Associate Professor) in Innovation & Technology Management at the University of Portsmouth
    • Jim Samuel, Associate Professor of Practice and Executive Director, Master of Public Informatics at the Bloustein School, Rutgers-New Brunswick
    • Alan Dennis, Professor of Information Systems and the John T. Chambers Chair of Internet Systems in the Kelley School of Business at IU Bloomington

    Details: Artificial intelligence news has escalated considerably in the last few months with the roll-out of Microsoft’s Bing Chatbot and the popularity of large language models (LLMs) such as ChatGPT. Popular social media app Snapchat has launched its chatbot called “My AI,” using the latest version of ChatGPT. Newswise Live is hosting a live expert panel on what to expect from AI in the near future, its impact on journalism, and the corporate race for AI dominance (Google vs. Microsoft, etc.). Panelists will discuss what we can expect from AI and Chatbots in the next three years.

    MEDIA REGISTER HERE

    Attention Journalists and Editors:

    A video and transcript of the event will be sent to those who register shortly after the event. Even if you can’t make this live virtual event, we encourage you to register to get a copy of these materials.

     

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    Newswise

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  • Long COVID linked to lower brain oxygen levels, cognitive problems and psychiatric symptoms

    Long COVID linked to lower brain oxygen levels, cognitive problems and psychiatric symptoms

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    Newswise — Long COVID is associated with reduced brain oxygen levels, worse performance on cognitive tests and increased psychiatric symptoms such as depression and anxiety, according to new research studying the impacts of the disease.  

    Researchers from the University of Waterloo combined the results of two new parallel studies: a laboratory study involving cognitive testing and imaging of oxygen levels in the brain, and a national population survey of Canadians in 2021 and 2022. 

    The laboratory study found that individuals who had experienced symptomatic COVID-19 illness performed worse on two computer tasks. One is measuring inhibition and another impulsive decision-making. Compared to those who had not been infected, people who had been infected showed a lack of increase in oxygen saturation in an area of the brain that is normally engaged during one of the tasks.  

    “We are the first to show reduced oxygen uptake in the brain during a cognitive task in the months following a symptomatic COVID-19 infection,” said Dr. Peter Hall, lead author and researcher in the School of Public Health Sciences at Waterloo. “This is important because a lack of sufficient oxygen supply is thought to be one of the mechanisms by which COVID-19 may cause cognitive impairment.” 

    The second study in this paper, a population survey of more than 2,000 Canadians aged 18 to 56, examined the relationships among COVID, cognitive function and psychiatric symptoms. Respondents who had COVID reported difficulty concentrating and problems with inhibition, as well as increased symptoms of anxiety and depression. These effects appeared to be marginally stronger among unvaccinated individuals and were still detectable after controlling for how long ago respondents were infected. 

    Previous studies have shown a link between COVID and test performance, self-reported cognitive symptoms and differences in brain structure measured by MRI, but not oxygenation changes in the brain. 

    Older women were more affected than others in the case of the brain imaging outcomes. “We don’t know for sure why this was the case, but there have been other studies showing that older women are especially impacted by some post-COVID-19 syndrome symptoms,” Hall said. 

    In the case of the population study, “It appears that, regardless of gender and other demographic factors, COVID-19 infection at baseline is correlated with increased problems with emotion regulation six months later: depression, anxiety and agitation. In some cases, we are talking about symptom levels that are at or above recommended as cut-off scores for psychiatric diagnoses,” Hall said. 

    The studies were conducted during earlier waves of the pandemic. The researchers did not examine whether Omicron and later variants have the same effects on the brain as earlier variants. 

    “Our two studies, using very different methods, highlight the need to understand the full range of harms of COVID-19 illness,” Hall said. “We still need to know more about how factors like vaccination affect the course of long COVID.  We also need to know about how some physical conditions like diabetes, obesity and hypertension might impact these mechanisms and outcomes.” 

    The paper, Neurocognitive and psychiatric symptoms following infection with COVID-19: Evidence from laboratory and population studies, was published in Brain, Behavior, and Immunity – Health and was co-authored by researchers at the University of Waterloo and Drexel University. 

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    University of Waterloo

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  • Loneliness is central to perinatal depression

    Loneliness is central to perinatal depression

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    Newswise — Loneliness can often contribute to depression in expectant and new mothers, finds a new review of evidence led by UCL researchers.

    The researchers say people working with expectant mothers, such as in antenatal classes or consultations, should be aware of the importance of loneliness and the value of encouraging new mothers to develop and maintain good social connections. The findings suggest that increased support from family and healthcare professionals can be helpful in reducing the mental health impacts of loneliness.

    Published in BMC Psychiatry, the meta-synthesis (an evidence review using a systematic method) of qualitative research pulled together accounts from 537 women, from 27 research papers on four continents.

    Lead author Dr Katherine Adlington (UCL Psychiatry and East London NHS Foundation Trust) said: “We found that loneliness was central to the experiences of expectant and new mothers with depression. We know that depression and loneliness are often interconnected – each one can lead to the other – and this may be particularly true for perinatal depression.

    “Having a baby is a period of huge transition and upheaval, that can involve losing touch with people and existing networks, such as work colleagues. This research suggests that loneliness is a major risk for mental health problems during pregnancy and for new mothers.”

    Depression is common during the perinatal period, affecting one in six pregnant women and one in five women during the first three months after birth, and can significantly affect new parents’ quality of life and can have long-term adverse impacts on their child’s cognitive and emotional development.

    For this review of evidence, the authors found that while very little research has been conducted specifically investigating loneliness in perinatal depression, loneliness came through prominently across the studies as a key contributing factor. 

    Some of the causes of loneliness included stigma, self-isolation, emotional disconnection and not receiving enough support. Many women reported a fear of judgement as a ‘bad mother’, and both perceived and experienced mental health stigma, which contributed to them hiding symptoms of mental ill-health and often led to self-isolation and withdrawal.

    Many women also reported a sudden sense of emotional disconnection after birth, from their previous lives before getting pregnant, from other mothers, and from the baby. Others also reported a mismatch between expected and actual support provided by their partner, their family, and their community more broadly. The researchers also identified a double burden faced by mothers from disadvantaged communities, due to increased stigma and decreased social support, highlighting the need for more targeted support that is culturally appropriate and without language barriers.

    The review also shed light on potential solutions. Many women reported that validation and understanding from healthcare professionals was helpful and may alleviate their loneliness, suggesting that clinical staff may have a greater than expected impact on reducing loneliness.

    Peer support from other mothers with experience of perinatal depression was also helpful – but only if those mothers had similar stories to share, as speaking to mothers who appeared to be doing well could in fact make loneliness worse.

    Senior author Professor Sonia Johnson (UCL Psychiatry and Camden and Islington NHS Foundation Trust), who co-leads the Loneliness and Social Isolation in Mental Health Network at UCL, said: “Helping women to understand early on in pregnancy how common loneliness is, and how it can lead to mental health problems, and that it’s okay to feel such feelings, could be an important way to reduce the impact of perinatal mental ill health.

    “We found that healthcare professionals also have an important role to play in helping women to feel heard and validated in their experiences of loneliness, so we would suggest that asking expectant and new mothers about potential feelings of loneliness could be highly beneficial, in addition to signposting them to peer support.

    “Peer, social and family support are likely to be crucial in reducing perinatal depression; this study helps understand the importance of social connection at this time, but there is a lot more to be done to understand why loneliness is so important in the perinatal period, and to develop effective ways of preventing or reducing it.”

    Notes to Editors

    Katherine Adlington, Cristina Vasquez, Eiluned Pearce, Claire A. Wilson, Rebecca Nowland, Billie Lever Taylor, Sarah Spring and Sonia Johnson, ‘‘Just snap out of it’ – the experience of loneliness in women with perinatal depression: a Metasynthesis of qualitative studies’, will be published in BMC Psychiatry on Tuesday 28 February 2023, 01:00 UK time and is under a strict embargo until this time.

    The DOI for this paper will be 10.1186/s12888-023-04532-2 and the paper will be published at https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-04532-2.

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    University College London

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  • The grassroots support that’s Taking Stock of farmers’ mental health

    The grassroots support that’s Taking Stock of farmers’ mental health

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    Newswise — The University of South Australia is ensuring that mental health and wellbeing remain a top priority in rural communities as a grassroots wellbeing and suicide prevention tool is launched today to support Australian farmers.

    The free online multimedia site – Taking Stock – has been designed by and for Australian farmers, to help them tackle the everyday struggles of living on the land.

    The outcome of a three-year nationally funded research project – ‘Tailoring Suicide Prevention Strategies to Men in Farming’Taking Stock helps farmers break down barriers for seeking help and provides information about community-based support services. Importantly, the website hosts resources tried by other rural groups that communities can download and use or adapt.

    It also helps farmers recognise that the distress, mental ill health and/or suicide ideation they may have experienced is also experienced by other farmers, helping them understand that they are not alone.

    This is the first time farmers have been asked about what they feel would help, and how they want to be supported.

    In Australia, suicide rates among farmers are alarming high. The rate of suicide in famers is nearly 59 per cent higher than non-farmers, and was up to 94 per cent higher in 2018.

    Project lead and Director of the National Enterprise for Rural Community Wellbeing, UniSA’s Professor Lia Bryant, says the needs of rural communities are at the heart of the Taking Stock initiative.

    “Rural people have tremendous knowledge about the challenges and opportunities that they face in rural areas, so working with farmers and support groups was absolutely essential to create strategies that have meaning and are more likely to be used,” Prof Bryant says.

    “In this project, we interviewed more than 50 farmers and three local suicide prevention groups – SOS Yorkes, Mellow in the Yellow, and Riverina Bluebell – to better understand the complexities of farmer distress and the local supports those farmers felt they needed.

    “We found that on top of key stress factors that affect farmers in general ­– things like weather extremes, physical isolation, intergenerational issues, and financial pressures, to name a few – there were additional shared risk factors that farmers in the same region (or farming the same commodity) experienced.

    “If we want suicide prevention strategies and early prevention to hit home then it was critical that we worked together to co-design a resource that directly addressed the key needs raised by farmers.

    “Wellbeing is more than an individual experience. It is created by strong community connections and having local support. Rural communities understand reciprocity: the giving and receiving of support in good times and in difficult times.

    Taking Stock shares the stories and lived experiences of farmers and explains their journeys from different perspectives. And, because it’s created by farmers and rural communities, for farmers and rural communities, the content is relevant and specific to their needs.”

    Taking Stock hosts multiple resources including films, interviews and podcasts of farmer experiences, how to set up a local suicide prevention group, and how to connect and engage with communities for early approaches to suicide prevention.

    The new website aligns with World Health Organization recommendations to adopt a whole-of-community strategy for suicide prevention. Place-based suicide prevention strategies are also central to Australia’s national response to suicide.

    Riverina Bluebell President, Stephen Matthews, says Taking Stock can also help communities create local suicide prevention groups.

    “Local knowledge and understanding are vital for supporting farmers, especially when it comes to mental health” Matthews says.

    “Early interventions are critical, but they must be tailored to the specific factors that give rise to farmer distress, while also capturing the culture of farming and rural communities.

    “By sharing how community-based support groups can make a difference to the lives of farmers doing it tough, and how communities can set up their own support groups, Taking Stock is covering all possible bases to improve mental health in rural and farming communities.

    “We’re very pleased to partner with UniSA to develop Taking Stock, and hope that the resource will not only provide immediate support for farmers in need, but also the resources to empower local communities to take positive action.”

    Notes to editors:

    • The study was undertaken across the Yorke Peninsula and Eyre Peninsula (SA), Tatyoon (VIC), and Wagga Wagga (NSW).
    • Taking Stock is the outcome of a 3 year nationally-funded research project with the following organisations funding the projection: Department of Primary Industries NSW • Agriculture Victoria, Department of Jobs, Precincts and Regions • Office of the Chief Psychiatrist SA (SA Health) • Wellbeing SA • National Mental Health Commission • Department of Primary Industries and Regions SA (PIRSA) • Superfriend and Queensland Mental Health Commission and Country SA Primary Health Network (for Stage 1 of the project).

     

     

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    University of South Australia

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  • Can the Lingering Effects of a Mild Case of COVID-19 Change Your Brain?

    Can the Lingering Effects of a Mild Case of COVID-19 Change Your Brain?

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    EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, MONDAY, FEBRUARY 20, 2023

    Newswise — MINNEAPOLIS – People with long COVID who experience anxiety and depression months after a mild case of COVID-19 may have brain changes that affect the function and structure of the brain, according to a preliminary study released today, February 20, 2023, that will be presented at the American Academy of Neurology’s 75th Annual Meeting being held in person in Boston and live online from April 22-27, 2023.

    “There is still much to learn about long COVID, which includes a wide range of health problems, including anxiety and depression, months after infection,” said Clarissa Yasuda, MD, PhD, of the University of Campinas in São Paulo, Brazil. “Our findings are concerning, as even people with a mild case of COVID-19 are showing changes in their brains months later. More studies are needed to hopefully identify treatments to prevent any long-term effects on people’s quality of life.”

    The study involved 254 people with an average age of 41 who had a mild COVID-19 infection an average of three months earlier. Participants completed tests to assess symptoms of depression and anxiety. A total of 102 people had symptoms of both anxiety and depression and 152 people had no symptoms.

    Participants also had brain scans. Researchers looked at damage to the brain’s gray matter to determine if there was brain shrinkage. They also compared the brain scans of the people with COVID-19 with the scans of 148 people who did not have a COVID-19 infection.

    The people with COVID-19 and anxiety and depression had shrinkage in the limbic area of the brain, which plays a role in memory and emotional processing, while the people who had COVID-19 without anxiety and depression and the people without COVID-19 had no brain shrinkage.

    Researchers also looked at brain function and changes in connectivity—how the brain communicates—between areas of the brain. Using a special type of software to analyze brain networks with resting-state brain activity, they looked at 84 people from the asymptomatic group, 70 people from the anxiety and depression group, and 90 people who did not have COVID-19.

    Researchers found that the group with both symptoms of anxiety and depression had widespread functional changes in each of the 12 networks that were tested, while the group without symptoms showed changes in only five networks.

    “Our results suggest a severe pattern of changes in how the brain communicates as well as its structure, mainly in people with anxiety and depression with long COVID syndrome, which affects so many people,” Yasuda added. “The magnitude of these changes suggests that they could lead to problems with memory and thinking skills, so we need to be exploring holistic treatments even for people mildly affected by COVID-19.”

    A limitation of the study was that symptoms of anxiety and depression were self-reported, so people may have misjudged or misreported symptoms.

    The study was supported by the São Paulo Research Foundation.

    Learn more about brain health at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.

    When posting to social media channels about this research, we encourage you to use the American Academy of Neurology’s Annual Meeting hashtag #AANAM.

    The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 38,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

    For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, Twitter, Instagram, LinkedIn and YouTube.

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    American Academy of Neurology (AAN)

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  • Addressing social isolation may be key in preventing mass shootings, study finds

    Addressing social isolation may be key in preventing mass shootings, study finds

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    Newswise — RICHMOND, Va. (Feb. 17, 2023) — An analysis of the psychological crises exhibited by 177 mass shooters has identified social isolation as the most important external indicator leading up to the attacks. The finding, which is based on research conducted at Virginia Commonwealth University, suggests that social isolation is an ideal candidate for acquaintances and communities of would-be shooters to intervene.

    “When we are isolated from our social circles, we lose that functional component of our loved ones being frank with us when our behavior might become inappropriate,” said Samuel West, Ph.D., an assistant professor of psychology at Virginia State University who led the study while he was a postdoctoral researcher at the Injury and Violence Prevention Research Lab at VCU Health.

    The study also found that the “mood swings” crisis indicator was one of the strongest predictors of a mass shooting’s severity. However, the authors concluded that social isolation was the most important because it acted as a “crisis multiplier” in that it allowed crises to increase the risk of other crises. For example, mood swings also increased the likelihood of paranoia, breaks with reality, and difficulties with daily tasks due to its connection with isolation.

    “It is easy to see how this perfect storm of multiple crises in someone who has isolated themselves could coalesce into more harmful thoughts and ultimately actions without the perspectives of others to act as a protective factor,” said West, who received his doctorate from the Department of Psychology in the College of Humanities and Sciences at Virginia Commonwealth University.

    West and co-author Nicholas Thomson, Ph.D., director of research and a forensic psychologist at the Injury and Violence Prevention Program, analyzed the data using psychometric network analysis, a new machine learning-based approach to exploring and visualizing complex relationships. They approached the study by focusing on psychological crises that nonexpert third parties — such as friends, family and co-workers — could observe and subsequently intervene.

    “Research on mass shootings is scarce, which limits our ability to develop targeted risk assessments and prevention strategies for mass shootings,” said Thomson, an associate professor in the Department of Surgery in the School of Medicine and the Department of Psychology in the College of Humanities and Sciences. “What Dr. West has achieved with the data is a step in the right direction for understanding the warning signs of people who commit mass shootings.”

    The study is novel in that the data collected is based on others’ perceptions of a mass shooter, Thomson said.

    “In many ways, this is the data that we need because others’ perceptions are integral to identifying and reporting at-risk individuals, and the community is critical to preventing violence,” he said. “Equipped with the right knowledge we can develop risk awareness strategies that can prevent mass shootings from occurring. Of course, this is only one piece of the puzzle, but it is an important piece.”

    The researchers see social isolation as an ideal target for intervention because it can be addressed both at the individual level and the societal level.

    “Although most people who experience isolation do not go on to commit such acts of violence, intervening on that isolation only holds benefits for the individual,” West said. “This can be as simple as a friend stopping by in person to say hello and catch up — something that we could all benefit from. Although this seems like it may not have such an impact, prior research makes clear that isolation is a necessary component of planning and carrying out a mass shooting as many of the behaviors involved (e.g., stockpiling guns and ammunition) are readily observable.”

    At the societal level, interventions could focus on building social ties and addressing isolation in communities.

    “One example could be to require students at public high schools to participate in civic events and organizations as part of their compulsory education,” West said. “On the other side of this coin, we also must consider that many of these individuals end up isolated for other reasons initially (i.e., social rejection). As such, working on the inclusivity of others overall while continuing to address bullying behavior in young people could be a fruitful avenue to improve the mental and social health of students and society at large.”

    Social isolation is also a good target for intervention because it was typically noticed significantly sooner, such as months or years before an attack, than other psychological crises, which tended to be observed days to weeks before an attack.

    “Although scientifically validated interventions for isolation exist, they have all been developed to address isolation in those who are seeking relief,” West said. “Such interventions would necessarily look different with would-be mass shooters as it is likely they would not willfully seek out such help on their own. Our work doesn’t speak to causality or any specific intervention that could be applied in this context.”

    The study, “Exploring Personal Crises Observed in Mass Shooters as Targets for Detection and Intervention Using Psychometric Network Analysis,” will be published in a forthcoming issue of the journal Psychology of Violence.

    The research was funded, in part, by a Centers for Disease Control and Prevention grant (1R01CE003296; PI Thomson) that was among 10 awarded nationally in 2020 to find ways to address gun violence.  

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    Virginia Commonwealth University (VCU)

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  • New UniSA-Teamgage initiative tackles workplace bullying from the ground up

    New UniSA-Teamgage initiative tackles workplace bullying from the ground up

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    Newswise — World-first research is at the heart of a new workplace bullying prevention program, launched today by the University of South Australia and Australian software business, Teamgage.

    The new programHealthy Workplaces by Design – identifies and mitigates the root causes of bullying, extending beyond more obvious interpersonal triggers into psychosocial hazards, such as workplace environments, workload demands, and working practices.

    As a risk audit and prevention program it will help businesses meet new work health and safety (WHS) obligations to proactively risk manage psychosocial hazards, especially workplace bullying.

    About 1.1 million Australian workers experience serious workplace bullying, with 39 percent of mental disorder claims caused by workplace bullying, harassment, or violence.

    Psychological health and safety are foremost on the agenda of Australian WHS policymakers, statutory agencies, and peak bodies, particularly since Safe Work Australia published the Model Code of Practice: Managing psychosocial hazards at work.

    UniSA researcher Professor Michelle Tuckey says the UniSA-Teamgage partnership will deliver a risk management process that uses work redesign to prevent workplace bullying and other psychosocial hazards.

    “Every employer has a legal responsibility to provide a safe workplace, but there’s an increasing pressure for businesses to better manage psychosocial risks, including workplace bullying and sexual harassment,” Prof Tuckey says.

    “Workplace bullying already causes up to $36 billion of lost productivity in each year. And with Safe Work Australia recording a 75 per cent increase in the frequency of bullying claims over the past ten years, it’s a problem that is not slowing down.

    “The amended legislation will require businesses to proactively address workplace bullying (and other psychosocial risks) with the same rigour as physical health and safety hazards, which means they’ll need to go above and beyond administrative controls like policies and training.

    “The UniSA + Teamgage partnership will enable businesses to undertake a tailored risk audit of their workplace and generate specific recommendations, actions, and evaluations to remedy any concerns.

    “It shifts the emphasis from responding to interpersonal bullying behaviour, to proactively identifying and mitigating the root causes of bullying embedded within work environments.”

    Trialled across 85 sites, Healthy Workplaces by Design has proven results, including:

    • 34 per cent reduction in exposure to bullying behaviour
    • 46 per cent reduction in workplace bullying complaints
    • 73 per cent reduction in sexual harassment complaints.

    Teamgage CEO and Co-Founder, Noelle Smit, says the UniSA-Teamgage partnership will ensure people have safer, healthier workplaces, in Australia, and around the world.

    “Teamgage is committed to helping organisations deliver strategic outcomes by creating highly effective teams,” Smit says.

    “We achieve this by empowering teams to continuously improve how they work together, and a part of this is by ensuring a safe and healthy workplace.

    “For this to happen, we need organisations to be constantly alive to the risk of workplace harassment, toxic cultures and mistrust between staff and management – all of which can affect performance, customer outcomes, profit and most importantly people’s wellbeing.

    “We’re thrilled to be partnering with the University of South Australia to deliver the new Healthy Workplaces by Design program and look forward to delivering safe, healthy workplaces for all.”

     

     

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    University of South Australia

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  • For leaders, playing favorites can be a smart strategy

    For leaders, playing favorites can be a smart strategy

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    Newswise — As anyone who’s worked in an office, a factory, or any other workplace can attest, sometimes bosses play favorites. Whether it’s assigning the most comfortable cubicles or the best parking spots, or deciding whose opinions take precedence during planning sessions, leaders inevitably wind up treating some employees better than others.

    That might seem unfair, especially if you aren’t your supervisor’s favorite. But now, for the first time, research shows that in some cases, biased bosses get better results — and not just from the workers they treat best.

    “For leaders, playing favorites isn’t always a bad thing,” explained Haoying (Howie) Xu, assistant professor of management at Stevens Institute of Technology. “Favoritism is a double-edged sword — it can be harmful to team dynamics, but in the right circumstances it can also help organizations to succeed.”

    In his work, reported in the February 2023 print issue of Personnel Psychology, Xu and colleagues studied more than 200 different teams, comprising over 1,100 employees, in several Chinese companies representing a cross-section of different industries. By surveying both employees and supervisors about performance and team dynamics, Xu was able to reveal the ways in which workplace favoritism interacts with other factors to elevate or impede overall team performance.

    The results were striking.

    In teams that were already well-structured, either because some employees were placed in positions of authority or because some employees had more advanced skill sets, performance dipped when leaders played favorites. In less clearly structured teams, however, having a biased boss typically led to better outcomes, with improved coordination and performance across the entire team.

    “That’s an important finding, because most previous research has focused solely on the negative impacts of workplace favoritism,” Xu said. “Now, we’re getting a more nuanced view of the way that leadership biases play out in the real world.”

    Drawing on a branch of management science known as leader-member exchange (LMX) theory, which studies the relationships between supervisors and employees, Xu argues that leadership biases operate by sending signals about the relative status of different team-members. That can be a bad thing: in teams where a social hierarchy already exists, favoritism can create dissonance and spark conflict.

    In teams that lack a clear pecking order, however, a leader’s biases impose structure and help everyone to work together more effectively. If team members don’t already have well-differentiated roles based on levels of authority or particular skills, favoritism provides a framework that reduces conflict and increases efficiency by helping employees to establish a stable dynamic instead of simply butting heads with one another.

    “In homogenous groups, playing favorites can be a way for leaders to clarify the roles that different team-members should play,” Xu explained. “When teams lack obvious hierarchies, it helps if the boss sends clear signals about who’s on top and who is expected to take a more subordinate role.”

    “The key point is that playing favorite has clear positive and negative effects, so leaders need to ensure they’re paying attention to how their favoritism is affecting their team.”

    Other factors can also influence the impact of leadership biases: more recently formed teams are more easily destabilized by workplace favoritism, for instance. Further research is needed to fully explore the way that favoritism works at different levels of organizations, and also to zoom in on the ways in which individual team-members’ interactions are influenced by their supervisor’s favoritism.

    For now, Xu’s research offers team supervisors and more senior managers clear guidance on how to optimize team performance. Managers could adjust their relationships with team-members to ensure they’re sending appropriate signals.

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    Stevens Institute of Technology

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  • Incivility reduces interest in what politicians have to say, shows research

    Incivility reduces interest in what politicians have to say, shows research

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    Newswise — Toronto — Nasty remarks by politicians against their critics are so common that we may not pay them much mind. That’s the problem of political incivility, say a pair of researchers who’ve studied the phenomenon among U.S. politicians.

    “The results are pretty clear,” says Matthew Feinberg, an associate professor of organizational behaviour at the University of Toronto’s Rotman School of Management. “Incivility may grab attention, but the ultimate result is less interest in what you have to say.”

    Prof. Feinberg and fellow researcher Jeremy A. Frimer from the University of Winnipeg already knew from their past work that incivility has been on the rise, especially online. In this most recent research, their analysis of rude and demeaning language in former U.S. president Donald Trump’s and current U.S. president Joe Biden’s social media posts revealed that the two gained fewer additional followers in the days after they made particularly uncivil comments.

    The researchers analyzed more than 32,000 tweets issued from Trump’s Twitter account between mid-2015 and Jan. 8, 2021, when he was permanently suspended from the platform. Over that time, Trump’s followers rose from 3 million to about 89 million. However, his biggest gains were made in the days after his tweets were particularly civil – about 43,000 new followers versus only 16,000 new followers after he was especially rude.

    The researchers used a machine-learning program that detects toxic speech and phrases to identify and classify the most uncivil tweets.

    In Biden’s case, the researchers analyzed just over 7,000 tweets between 2012 and June 2021. His followers rose from 5 million to 32 million over that time. He gained an average of 45,000 new followers when his tweets were very civil but only 11,000 in the days after they were not.

    Prof. Feinberg said the steeper drop in new followers for Biden may be due to people expecting more civil behaviour from him than Trump. However, the researchers estimated that Trump’s incivility cost him more than 6.3 million followers.

    Two additional experimental studies that formed part of the research, with a total of about 2,000 participants confirmed the finding that political incivility breeds longer-term disinterest. That was true even when the participant identified with the same political party, something Prof. Feinberg called “surprising.” As well, the third study showed that moral disapproval of what a politician said had a stronger influence on a person’s ongoing interest than whether the politician’s words were attention-grabbing.

    So given the results, how come politicians continue to lob rhetorical grenades at one another? It’s possible they do it because they may inflict greater damage on their opponents’ reputations or even turn voters off so much that they don’t even bother going to the polls, the researchers suggest. Or, says Prof. Feinberg, “maybe it’s just that they’re wrong.”

    The study was published in Social Psychological and Personality Science.

    Bringing together high-impact faculty research and thought leadership on one searchable platform, the new Rotman Insights Hub offers articles, podcasts, opinions, books and videos representing the latest in management thinking and providing insights into the key issues facing business and society. Visit www.rotman.utoronto.ca/insightshub.

    The Rotman School of Management is part of the University of Toronto, a global centre of research and teaching excellence at the heart of Canada’s commercial capital. Rotman is a catalyst for transformative learning, insights and public engagement, bringing together diverse views and initiatives around a defining purpose: to create value for business and society. For more information, visit www.rotman.utoronto.ca

    -30-

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  • Commonly used police diversity training unlikely to change officers’ behavior, study finds

    Commonly used police diversity training unlikely to change officers’ behavior, study finds

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    Newswise — Tyre Nichols, a 29-year-old Black man who died after a confrontation with police during a traffic stop earlier this month in Memphis, has become the latest face in a racial justice and police reform movement fueled by a string of similar cases in which Black men have died from injuries sustained while being taken into custody.

    While these cases have spurred calls for greater law enforcement investment in diversity training, new research from Washington University in St. Louis suggests that the day-long implicit bias-oriented training programs now common in most U.S. police departments are unlikely to reduce racial inequity in policing.

    “Our findings suggest that diversity training as it is currently practiced is unlikely to change police behavior,” said study lead author Calvin Lai, assistant professor of psychological and brain sciences in Arts & Sciences at Washington University in St. Louis.

    “Officers who took the training were more knowledgeable about bias and more motivated to address bias at work,” Lai said.” However, these effects were fleeting and appear to have little influence on actual policing behaviors just one month after the training session.”

    Published Feb. 3 in the journal Psychological Science, the study evaluates the experiences of 3,764 police officers from departments across the nation who participated in one-day bias training sessions provided by the non-profit Anti-Defamation League.

    The interactive workshops, which emphasize discussion and active learning over lecturing, were designed to help officers understand how their worldview is shaped by their identity and culture and to appreciate how these biases may affect their behavior.

    Lai’s evaluation of the program, which covered 251 training sessions held between July 2019 and January 2022, is based on police officers’ self-reported responses to surveys conducted before training, immediately after training and one month later.

    When officers were asked to describe their thoughts about the training, many reported that it was surprising and insightful. For instance, one officer wrote “it has opened my eyes to the bias we all have as human beings” and another said, “I really liked the course because it opened my eyes to implicit biases I never knew I had.”

    Officers participating in the study had an average of 15 years of service and most had been with their departments for more than five years. Most were below the rank of sergeant, 77% were male and 79% held a bachelor’s degree or higher. Among those who reported their race, 47% were white, 20% were Black, 27% were Hispanic/Latino and 2% were Asian.

    The final section of the training program focused on building skills to manage bias in policing. These strategies included mindfulness, such as intentionally bringing bias awareness to the present moment, and other interventions designed to help officers avoid perceptions based on negative stereotypes and see people as unique individuals with their own points of view.

    While the training produced an immediate and long-lasting understanding of bias, it delivered only a temporary bump in concerns about bias and in the motivation to use strategies to limit bias in law enforcement interactions.

    “Educating about implicit bias was effective for durably raising awareness about the existence of subtle or implicit biases, but little else,” Lai said. “Our study indicates that the current generation of diversity training programs are effective at changing minds but less consistent at changing behavior.”

    Lai, who is currently working with the U.S. Department of Justice’s Office of Community Oriented Policing Services to develop a new managing bias training course for law enforcement agencies, says it’s important to manage expectations about what can be accomplished in a single, standalone training session.

    His study documents shortcomings in the Anti-Defamation League’s Managing Bias program, which he considers to be one of the nation’s best available diversity training programs. The program is research-based, comes with an 80-page instruction manual and is delivered by two-person teams of highly trained facilitators.

    “The day-long training is more intensive than other diversity trainings, which are often only one to three hours,” Lai said. “And yet, we found little evidence for long-term efficacy.”

    Lai’s research suggests that police departments can boost the effectiveness of diversity training by showing a genuine, long-term commitment to program goals and ensuring that classroom bias training lessons are embedded with other organizational initiatives, reinforced by police managers and evaluated as a part of job performance.

    “Changing minds is hard, creating social change is difficult, but that doesn’t mean it isn’t worth doing,” Lai said. “We have to eliminate this all-or-none thinking about the effectiveness of implicit bias training and focus on specific changes that police departments can implement to make a real difference in outcomes.”

    This study was supported by grants from the Anti-Defamation League and the Russell Sage Foundation. Co-authors include Jacklyn Lisnek, a former lab manager in Lai’s lab now pursuing a doctoral degree in social psychology at the University of Virginia.

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    Washington University in St. Louis

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  • February 2023 Issue of Neurosurgical Focus: “Neurosurgical Management of Psychiatric Disease”

    February 2023 Issue of Neurosurgical Focus: “Neurosurgical Management of Psychiatric Disease”

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    Newswise — Rolling Meadows, IL (February 1, 2023). The February issue of Neurosurgical Focus (Vol. 54, No. 2 [https://thejns.org/focus/view/journals/neurosurg-focus/54/2/neurosurg-focus.54.issue-2.xml]) presents seven articles on the neurosurgical management of psychiatric disease.

    Topic Editors: Sameer A. Sheth, G. Rees Cosgrove, and Nicole C. R. McLaughlin

    Calling attention to the need to reduce the “the ever-narrowing gap between neurosurgery and neuroscience”, the Topic Editors of the February issue of Neurosurgical Focus have selected articles to produce a collection that “features a number of articles detailing the history of psychiatric neurosurgery and provides modern day examples of its continued success.”

    Contents of the February issue: 

    • “Introduction. Neurosurgical neuroscience” by Sameer A. Sheth et al.
    • The Surgeon, or The Extraction of the Stone of Madness, by Jan Sanders van Hemessen (c 1500–1566)” by Eric J. Chalif
    • “Intracranial subsecond dopamine measurements during a “sure bet or gamble” decision-making task in patients with alcohol use disorder suggest diminished dopaminergic signals about relief” by Brittany Liebenow et al.
    • “Stereotactic electroencephalography in epilepsy patients for mapping of neural circuits related to emotional and psychiatric behaviors: a systematic review” by Christian G. Lopez Ramos et al.
    • “Efficacy of deep brain stimulation for the treatment of anorexia nervosa: a systematic review and network meta-analysis of patient-level data” by Annabelle Shaffer et al.
    • “Novel psychiatric disorders following mild traumatic brain injury: a retrospective multivariable analysis with screening recommendations” by Alexander M. Ballatori et al.
    • “Schizophrenia and neurosurgery: systematic review and theories” by Rajeev R. Dutta et al.
    • “Neurosurgery for psychiatric disorders: reviewing the past and charting the future” by Luke Bauerle et al.

     

    Please join us in reading this month’s issue of Neurosurgical Focus.

    ***

     ###

    The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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    Journal of Neurosurgery

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  • Β-blocker use associated with lower rates of violence

    Β-blocker use associated with lower rates of violence

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    Newswise — Reductions in violence are seen in individuals using Beta adrenergic-blocking agents (β-blockers) compared with periods that they are not taking the medication, in a study published January 31st in the open access journal PLOS Medicine. If the findings are confirmed by other studies, β-blockers could be considered as a way to manage aggression and hostility in individuals with psychiatric conditions.

    β-blockers are used to treat hypertension, angina and acute cardiovascular events, heart failure and arrhythmias as well as, migraine, symptoms of hyperthyroidism and glaucoma. They are often used for anxiety and have been suggested for clinical depression and aggression, but evidence is conflicting. They have been linked to an increased risk of suicidal behavior though evidence is inconclusive.

    Seena Fazel of the University of Oxford, UK, and colleagues at the Karolinska Institute in Sweden investigated psychiatric and behavioral outcomes: hospitalizations for psychiatric disorders; suicidal behavior and deaths from suicide; and charges of violent crime. They compared 1.4 million β-blocker users in Sweden to themselves during medicated and non-medicated periods over an eight-year period from 2006-2013.

    Periods on β-blocker treatment were associated with a 13% lower risk of being charged with a violent crime by the police, which remained consistent across the analyses. Additionally, an 8% lower risk of hospitalization due to a psychiatric disorder was reported as well as an 8% increased association of being treated for suicidal behavior. However, these associations varied depending on psychiatric diagnosis, past psychiatric problems, as well as the severity and type of the cardiac condition the β-blockers were being used to treat.

    Previous research has linked severe cardiac events to an increased risk of depression and suicide, and these results might suggest that the psychological distress and other disabilities associated with serious cardiac problems, rather than the β-blocker treatment, increases the risk of serious psychiatric events. In secondary analyses, associations with hospitalization were lower for major depressive but not for anxiety disorders.

    In order to understand the role of β-blockers in the management of aggression and violence, further studies including randomized controlled trials are needed. If these confirm the results of this study, β-blockers could be considered to manage aggression and violence in some individuals.

    Fazel adds, “In a real-world study of 1.4 million persons, β-blockers were associated with reduced violent criminal charges in individuals with psychiatric disorders. Repurposing their use to manage aggression and violence could improve patient outcomes.”

    #####

    In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicine:

    http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004164

    Press-only preview: https://plos.io/3XFCyJF

    Citation: Molero Y, Kaddoura S, Kuja-Halkola R, Larsson H, Lichtenstein P, D’Onofrio BM, et al. (2023) Associations between β-blockers and psychiatric and behavioural outcomes: A population-based cohort study of 1.4 million individuals in Sweden. PLoS Med 20(1): e1004164. https://doi.org/10.1371/journal.pmed.1004164

    Author Countries: Sweden, United Kingdom, United States of America

    Funding: This study was supported by the Wellcome Trust (No 202836/Z/16/Z): https://wellcome.org/grant-funding (SF), the Swedish Research Council for Health Working Life and Welfare (2015-0028): https://forte.se/en/ (PL and HL), the American Foundation for Suicide Prevention (DIG-1-037-19): https://afsp.org/research-grant-information (BMD), and Karolinska Institutet Funds (2016fobi50581): https://staff.ki.se/ki-foundations-funds-list-of-grants (YM). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

    Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: HL reports receiving grants from Shire Pharmaceuticals; personal fees from and serving as a speaker for Medice, Shire/Takeda Pharmaceuticals and Evolan Pharma AB; and sponsorship for a conference on attention-deficit/hyperactivity disorder from Shire/Takeda Pharmaceuticals and Evolan Pharma AB, all outside the submitted work. All other authors have declared that no competing interests exist.

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    PLOS

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  • Events Serve as “Stepping Stones” en Route to Retrieved Memories

    Events Serve as “Stepping Stones” en Route to Retrieved Memories

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    Newswise — “Dang it, I lost my keys!” 

    One solution to this frustratingly common scenario is to retrace your steps. This can be done by physically moving through the space where you suspect your elusive keychain is hiding or, as explored in recent research in Psychological Science, scanning your memory to find them. 

    Humans structure memories of these kinds of continuous experiences using event boundaries, according to lead author Sebastian Michelmann, who conducted this research with Uri Hasson and APS Fellow Kenneth A. Norman (Princeton University). 

    “Intuitively, we perceive structure in the form of events in continuous experience. A ‘restaurant visit’ and a ‘train ride’ are examples of such events,” Michelmann said in an interview. “When one event ends and another begins, people perceive an event boundary, and human observers agree substantially on the exact moments when an event boundary happens.” 

    Michelmann and colleagues’ research suggests that people use these event boundaries as “stepping stones” to scan their memories when attempting to recall certain facts or bits of information. In the case of the lost keys, he said, this might involve reaching back to the last moment you clearly remember having your keys—say, as you walked in the front door—before skipping ahead to a “phone call” event and then a “watching TV” event, at which point you might recall placing the keys next to the remote. 

    “When people search through continuous memories, they can do that slowly and thoroughly, but they can also skip ahead to the next event boundary when they decide that the answer that they are looking for is not in the current event,” Michelmann said. “Event boundaries are important access points for this skipping, which is why we refer to them as stepping stones in the memory search process.” 

    Michelmann, Hasson, and Norman examined this process through a series of three online studies in which participants were tasked with scanning their memories for details about two seven-minute abridged versions of the film Gravity.  

    In the first study, the researchers established event boundaries within each short film by having 104 participants press a button each time they perceived an event to have ended. As in previous research, the participants’ perceptions of event boundaries were highly consistent. 

    In the second study, 180 participants answered questions about the events in both short films. Each question started by identifying an anchor event in the film before asking the participant to recall information that occurred after this point. For example, “In the space station, we see little flames flying into the hallway. When is the next time we see fire?” The questions were designed to involve either a single isolated event or a specific number of event boundaries with a set run time. After being presented with the question, participants were instructed to click a “Respond” button as soon as they remembered the answer. 

    By comparing the actual run time of each event or set of events with how long it took participants to click the response button, Michelmann and colleagues determined that individuals were able to scan 1 second of an event in about 48 milliseconds. Participants scanned, on average, just 1.9 second of an event before skipping ahead to the next one if they did not find the information they were looking for. The researchers found their stepping-stones model of memory scanning, which accounts for the time at which the target information appears within an event and, consequently, the target’s distance to event boundaries, to be a better fit for participants’ responses than a model based only on the length of each event being scanned. 

    “The stepping-stones model predicts that the target’s distance to the previous event boundary makes a high relative contribution to [response times] because a low skipping threshold ensures that little time is spent within each event; the final event, however, is searched without skipping,” Michelmann and colleagues wrote. 

    The researchers further tested this model through a third study of 100 participants. This time, participants were asked to mentally simulate or “replay” everything that happened between two event boundaries in each film. Although participants still engaged in some amount of temporal compression, they took more time to review fully simulated events than participants did when looking for information, suggesting that we recall events with a higher skipping threshold when simulating versus scanning our memories. 

    “Search time can be explained using a model in which participants skip through all events except the last one, which needs to be played through in its entirety to find the sought-after memory that it contains,” Michelmann and colleagues wrote. 

    In future work, Michelmann would like to explore how schematic knowledge about information in our environment interacts with episodic memory to support recall of specific versus typical experiences. Remembering what a typical birthday party is like could support recall of specific details about an individual’s 30th birthday celebration, for example, but relying too much on these schemata could also cloud our memories of unique details, he said. 

    Reference 

    Michelmann, S., Hasson, U., & Norman, K. A. (2023). Evidence that event boundaries are access points for memory retrieval. Psychological Science. https://journals.sagepub.com/doi/full/10.1177/09567976221128206 

    Journalists: Request a copy of this article by emailing [email protected]

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    Association for Psychological Science

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  • Fear of Public Places Is Common in Adults with Epilepsy

    Fear of Public Places Is Common in Adults with Epilepsy

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    Newswise — About 5.1 million people in the U.S. have a history of epilepsy, which causes repeated seizures. According to the Epilepsy Foundation, epilepsy is the fourth most common neurological disorder. While current research has shown an increase in anxiety and depression among people with epilepsy, little is known about this population and agoraphobia, an anxiety disorder that involves the fear of being in a public place or in a situation that might cause panic or embarrassment.

    However, a recent study from Heidi Munger Clary, M.D., M.P.H., associate professor of neurology at Wake Forest University School of Medicine, shows that phobic and agoraphobic symptoms are common and associated with poor quality of life in people with epilepsy.

    The study appears online in Epilepsy Research.

    “We know that agoraphobia can lead to delays in patient care because of a reluctance to go out in public, which includes appointments with health care providers,” said Munger Clary, the study’s principal investigator. “So, this is an area that needs more attention in clinical practice.”

    In the study, researchers conducted a cross-sectional analysis of baseline clinical data from a neuropsychology registry cohort study. Researchers analyzed a diverse sample of 420 adults, ages 18 to 75, with epilepsy who underwent neuropsychological evaluation over a 14-year period at Columbia University Medical Center in New York.

    “More than one-third of the participants reported significant phobic/agoraphobic symptoms,” Munger Clary said. “We also found that phobic/agoraphobic symptoms, along with depression symptoms, were independently associated with poor quality of life, but generalized anxiety symptoms were not.” 

    According to Munger Clary, because phobic/agoraphobic symptoms are not routinely assessed by clinicians, the findings may suggest a need for future studies to develop more comprehensive screeners for psychiatric comorbidity in epilepsy.

    “Symptoms of agoraphobia do not fully overlap with generalized anxiety or depression symptoms that are often screened in routine practice,” Munger Clary said. “Providers might want to consider more robust symptom screening methods to identify and better assist these patients. This may be important to improve health equity, given other key study findings that show those with lower education and non-white race/ethnicity had increased odds of significant phobic/agoraphobic symptoms.”

    This work was supported in part by the National Institutes of Health under grants R01 NS035140, KM1 CA156709, UL1 TR001420 and 5KL2TR001421-04. 

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    Wake Forest University School of Medicine

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  • Suicide Risk Higher Among Individuals with Cancer, New Study Shows

    Suicide Risk Higher Among Individuals with Cancer, New Study Shows

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    EMBARGOED FOR RELEASE – 11:00 a.m., ET – January 20, 2023

    Newswise — ATLANTA, January 20, 2023 — According to a new large study led by researchers at the American Cancer Society (ACS), the risk of suicide for individuals diagnosed with cancer in the United States is 26% higher compared with the general population. Geographic, racial/ethnic, socioeconomic, and clinical characteristics contributed to the elevated risk. The study also shows a decline in elevated risk for individuals with cancer compared with the general population from 67% in 2000 to 16% in 2016. The research is to be published today in the Journal of the American Medical Association (JAMA) Network Open.

    “Our findings highlight the importance of timely symptom management and targeted interventions for suicide prevention in individuals with cancer,” said Dr. Xuesong Han, scientific director, health services research at the American Cancer Society and senior author of the study. “These require joint efforts by federal and state governments, as well as healthcare providers, to ensure comprehensive health insurance coverage for psycho-oncological, psychosocial, and palliative care, development of appropriate clinical guidelines for suicide risk screening, and inclusion of suicide prevention in survivorship care plans.”

    For the study, researchers analyzed data of 16.8 million individuals diagnosed with cancer in 43 states in the U.S. from 2000-2016. They used the Cancer Incidence in North America (CiNA) Survival dataset compiled by the North American Association of Central Cancer Registries (NAACCR), which contained data from the Centers for Disease Control and Prevention (CDC) National Program of Cancer Registries (NPCR) and the National Cancer Institute (NCI) SEER Registries. Standardized Mortality Ratios (SMR) were calculated based on attained age at death, sex, and race/ethnicity to compare suicide risks in individuals with cancer versus the general population. Cox proportional hazard models were fitted to identify cancer-specific risk factors of suicide among individuals diagnosed with cancer.

    The results showed 20,792 individuals with cancer died from suicide during 2000-2016. Compared to the general population, elevated suicide risk was observed across all sociodemographic groups, with particularly higher risks among Hispanics, Medicaid-insured, Medicare-insured aged under 64 years old, or uninsured. The highest suicide risk was observed in the first six months following a cancer diagnosis, with the rate more than seven times higher than the general population. Among individuals diagnosed with cancer, relatively higher suicide risks were observed for poor prognosis cancer types with high symptom burdens in the first two years following diagnosis, including cancers of oral cavity & pharynx, esophagus, stomach, brain, pancreas, and lung. After two years, individuals with cancers subject to long-term quality-of-life impairments, such as oral cavity & pharynx, female breast, uterine, bladder, and leukemia, had higher suicide risks.

    “The overall decreasing trend in suicide risk suggests a positive role of the coinciding promotion of psychosocial and palliative care and advances in symptom control and pain management,” said Xin Hu, Ph.D. candidate at Emory University and lead author of the study. “But more needs to be done. Examining the associations of clinical factors such as cancer treatments as well as policy factors with suicide risk and evaluating psychosocial interventions are important areas for future research.”

    Other ACS study authors include: Jingxuan Zhao, Dr. Ahmedin Jemal, Dr. Jiemin Ma, Dr. Leticia Nogueira, and Dr. Robin Yabroff.

                                                                                                                           # # #

    About the American Cancer Society The American Cancer Society is a leading cancer-fighting organization with a vision to end cancer as we know it, for everyone. For more than 100 years, we have been improving the lives of people with cancer and their families as the only organization combating cancer through advocacy, research, and patient support. We are committed to ensuring everyone has an opportunity to prevent, detect, treat, and survive cancer. To learn more, visit cancer.org or call our 24/7 helpline at 1-800-227-2345. Connect with us on Facebook, Twitter, and Instagram.

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    American Cancer Society (ACS)

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  • COVID is changing how we are exposed to household health risks

    COVID is changing how we are exposed to household health risks

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    Newswise — COVID-19 is changing household behaviors related to how we are exposed to various household chemicals linked to poor health outcomes. People surveyed earlier in the pandemic were using less personal care products but more household cleaners, eating less fast food and restaurant food but more ultra-processed food. These changes which occurred since the pandemic onset are also linked to pandemic-related traumatic stress, which itself may worsen health outcomes.

    Researchers at Columbia University Mailman School of Public Health along with partners from Dartmouth College, as part of the Environmental influences on Child Health Outcomes (ECHO) consortium, analyzed responses to a survey from 1,535 adults in six states. Results are published in the journal PLOS ONE.

    Personal care products. Overall, participants reported using fewer personal care products, including hair products (perms or relaxers, hair dye, hair sprays, hair gels) and makeup/body products (nail polish, make-up, perfume, lotion) since the start of the pandemic. Participants who experienced more pandemic-related traumatic stress were more likely to report using fewer hair products and cosmetics. Approximately half of all respondents reported using more liquid soaps (52%) and antibacterial soaps (48%) and 81 percent of respondents reported using more hand sanitizer gels. The use of all three products was associated with pandemic-related traumatic stress symptoms.

    Household cleansers. Two-thirds of respondents reported using more antibacterial cleaners and 54 percent reported using more bleach-containing cleaning products—changes made more likely among those experiencing more pandemic-related traumatic stress.

    Food-related behaviors. Nearly half (49%) of respondents said they eat more home-cooked meals because of the pandemic. One-third (34%) of respondents reported eating less fast food since the start of the pandemic. Both of these behavior changes were more common among those with more symptoms of pandemic-related traumatic stress. In all, 12 percent reported eating more ultra-processed foods, and 24 percent reported eating less processed foods, with the latter more likely among those with symptoms of pandemic-related traumatic stress.

    The Upshot

    While the study did not include measurements of environmental exposures, the researchers say that the scientific literature suggests that these behavior changes likely reflect changes in their exposures to environmental chemicals. They also likely reflect changes—both good and bad—to health outcomes linked to these chemicals.

    “We can infer that some behaviors like less consumption of fast foods and less use of personal care products might lower exposures to some phthalates and phenols, while greater use of personal and household cleansers may be associated with higher exposure to quaternary ammonium compounds and glycol ethers; and more frequent consumption of ultra-processed food could increase exposure to phthalates and phenols,” says lead author Julie Herbstman, PhD, director of the Columbia Center for Children’s Environmental Health (CCCEH) and professor of environmental health sciences.

    Phthalates are linked asthma, attention-deficit hyperactivity disorder, breast cancer, obesity and type II diabetes and neurodevelopmental and behavioral issues. Phenols like BPA are linked to reproductive dysfunction, reduced birth size, cognitive and/or behavior outcomes, asthma, and obesity. Quaternary ammonium compounds are skin irritants and can also lead to asthma exacerbations. Exposure to glycol ethers may also irritate skin, eyes, nose, and throat and may also lead to anemia and/or adverse reproductive outcomes like birth defects.  

    A Roadmap to Interventions

    The study identifies several factors that make some of these behavior changes more likely, including symptoms of pandemic-related traumatic stress and living in a household where someone tested positive for COVID-19, as well as race/ethnicity. Going forward, the researchers plan to repeat their analysis, adding a biological measure of chemical exposures to assess whether the trends in pandemic-related behavior change reported here do, in fact, result in shifts in exposures measured through biomarkers of internal dose. They also say it is important to continue to monitor pandemic-related behavior change as pandemic severity waxes and wanes.

    The researchers say their study could lead to an intervention to reduce exposure to harmful environmental chemicals.

    “Interventions and campaigns targeting the reduction of environmental exposures, pandemic-related traumatic stress, as well as those that facilitate behavior change can help improve health outcomes that are indirectly related to the pandemic,” says Herbstman.

    The study’s senior authors are Frederica Perera, director of the translational research program at CCCEH and professor of environmental health sciences at Columbia Mailman School of Public Health, and Margaret R. Karagas, professor and chair of epidemiology at the Geisel School of Medicine at Dartmouth. A full list of co-authors is available in the journal article.

    Funding for the research was provided by grants from the National Institutes of Heath (U2COD023375, U24OD023382, U24OD023382, U24OD023319, UH3OD023290, UH3OD023275, UH3OD023272, UH3OD023271, UH3OD023313).

    The authors declare no conflicts.

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    Columbia University, Mailman School of Public Health

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  • Deep meditation may alter gut microbes for better health

    Deep meditation may alter gut microbes for better health

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    Newswise — Regular deep meditation, practised for several years, may help to regulate the gut microbiome and potentially lower the risks of physical and mental ill health, finds a small comparative study published in the open access journal General Psychiatry.

    The gut microbes found in a group of Tibetan Buddhist monks differed substantially from those of their secular neighbours, and have been linked to a lower risk of anxiety, depression, and cardiovascular disease.

    Research shows that the gut microbiome can affect mood and behaviour through the gut–brain axis. This includes the body’s immune response, hormonal signalling, stress response and the vagus nerve—the main component of the parasympathetic nervous system, which oversees an array of crucial bodily functions.

    The significance of the group and specimen design is that these deep-thinking Tibetan monks can serve as representatives of some deeper meditations. Although the number of samples is small, they are rare because of their geographical location.

    Meditation is increasingly being used to help treat mental health disorders, such as depression, anxiety, substance abuse, traumatic stress, and eating disorders as well as chronic pain. But it’s not clear if it might also be able to alter the composition of the gut microbiome, say the researchers.

    In a bid to find out, the researchers analysed the stool and blood samples of 37 Tibetan Buddhist monks from three temples and 19 secular residents in the neighbouring areas.

    Tibetan Buddhist meditation originates from the ancient Indian medical system known as Ayurveda, and is a form of psychological training, say the researchers. The monks in this study had been practising it for at least 2 hours a day for between 3 and 30 years.

    None of the participants had used agents that can alter the volume and diversity of gut microbes: antibiotics; probiotics; prebiotics; or antifungal drugs in the preceding 3 months.

    Both groups were matched for age, blood pressure, heart rate, and diet.

    Stool sample analysis revealed significant differences in the diversity and volume of microbes between the monks and their neighbours. 

    Bacteroidetes and Firmicutes species were dominant in both groups, as would be expected. But Bacteroidetes were significantly enriched in the monks’ stool samples (29% vs 4%), which also contained abundant Prevotella (42% vs 6%) and a high volume of Megamonas and Faecalibacterium.

    “Collectively, several bacteria enriched in the meditation group [have been] associated with the alleviation of mental illness, suggesting that meditation can influence certain bacteria that may have a role in mental health,” write the researchers.

    These include Prevotella, Bacteroidetes, Megamonas and Faecalibacterium species, the previously published research suggests.

    The researchers then applied an advanced analytical technique to predict which chemical processes the microbes might be influencing. This indicated that several protective anti-inflammatory pathways, in addition to metabolism—the conversion of food into energy—were enhanced in the meditation people.

    Finally, blood sample analysis showed that levels of agents associated with a heightened risk of cardiovascular disease, including total cholesterol and apolipoprotein B, were significantly lower in the monks than in their secular neighbours by their functional analysis with the gut microbes.

    Although a comparative study, it is observational and the numbers of participants were small, all male, and lived at high altitude, making it difficult to draw any firm or generalisable conclusions. And the potential health implications could only be inferred from previously published research.

    But based on their findings, the researchers suggest that the role of meditation in helping to prevent or treat psychosomatic illness definitely merits further research.

    And they conclude: “These results suggest that long-term deep meditation may have a beneficial effect on gut microbiota, enabling the body to maintain an optimal state of health.”

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    BMJ

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  • How your mood affects the way you process language

    How your mood affects the way you process language

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    Newswise — When people are in a negative mood, they may be quicker to spot inconsistencies in things they read, a new University of Arizona-led study suggests.

    The study, published in Frontiers in Communication, builds on existing research on how the brain processes language.

    Vicky Lai, a UArizona assistant professor of psychology and cognitive science, worked with collaborators in the Netherlands to explore how people’s brains react to language when they are in a happy mood versus a negative mood.

    “Mood and language seem to be supported by different brain networks. But we have one brain, and the two are processed in the same brain, so there is a lot of interaction going on,” Lai said. “We show that when people are in a negative mood, they are more careful and analytical. They scrutinize what’s actually stated in a text, and they don’t just fall back on their default world knowledge.”

    Lai and her study co-authors set out to manipulate study participants’ moods by showing them clips from a sad movie – “Sophie’s Choice” – or a funny television show – “Friends.” A computerized survey was used to evaluate participants’ moods before and after watching the clips. While the funny clips did not impact participants’ moods, the sad clips succeeded in putting participants in a more negative mood, the researchers found.

    The participants then listened to a series of emotionally neutral audio recordings of four-sentence stories that each contained a “critical sentence” that either supported or violated default, or familiar, word knowledge. That sentence was displayed one word at a time on a computer screen, while participants’ brain waves were monitored by EEG, a test that measures brain waves.

    For example, the researchers presented study participants with a story about driving at night that ended with the critical sentence “With the lights on, you can see more.” In a separate story about stargazing, the same critical sentence was altered to read “With the lights on, you can see less.” Although that statement is accurate in the context of stargazing, the idea that turning on the lights would cause a person to see less is a much less familiar concept that defies default knowledge.

    The researchers also presented versions of the stories in which the critical sentences were swapped so that they did not fit the context of the story. For example, the story about driving at night would include the sentence “With the lights on, you can see less.”

    They then looked at how the brain reacted to the inconsistencies, depending on mood.  

    They found that when participants were in a negative mood, based on their survey responses, they showed a type of brain activity closely associated with re-analysis.

    “We show that mood matters, and perhaps when we do some tasks we should pay attention to our mood,” Lai said. “If we’re in a bad mood, maybe we should do things that are more detail-oriented, such as proofreading.”

    Study participants completed the experiment twice – once in the negative mood condition and once in the happy mood condition. Each trial took place one week apart, with the same stories presented each time.

    “These are the same stories, but in different moods, the brain sees them differently, with the sad mood being the more analytical mood,” Lai said.

    The study was conducted in the Netherlands; participants were native Dutch speakers, and the study was conducted in Dutch. But Lai believes their findings translate across languages and cultures.

    By design, the study participants were all women, because Lai and her colleagues wanted to align their study with existing literature that was limited to female participants. Lai said future studies should include more diverse gender representation.

    In the meantime, Lai and her colleagues say mood may affect us in more ways than we previously realized.

    Researcher Jos van Berkum of the Netherlands’ Utrecht University, co-authored the study with Lai and Peter Hagoort of the Max Planck Institute for Psycholinguistics in the Netherlands.

    “When thinking about how mood affects them, many people just consider things like being grumpy, eating more ice cream, or – at best – interpreting somebody else’s talk in a biased way,” van Berkum said. “But there’s much more going on, also in unexpected corners of our minds. That’s really interesting. Imagine your laptop being more or less precise as a function of its battery level – that’s unthinkable. But in human information processing, and presumably also in (information processing) of related species, something like that seems to be going on.”

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    University of Arizona

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  • Evolution of uniquely human DNA was a balancing act, study concludes

    Evolution of uniquely human DNA was a balancing act, study concludes

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    Newswise — SAN FRANCISCO, CA—January 13, 2023—Humans and chimpanzees differ in only one percent of their DNA. Human accelerated regions (HARs) are parts of the genome with an unexpected amount of these differences. HARs were stable in mammals for millennia but quickly changed in early humans. Scientists have long wondered why these bits of DNA changed so much, and how the variations set humans apart from other primates.

    Now, researchers at Gladstone Institutes have analyzed thousands of human and chimpanzee HARs and discovered that many of the changes that accumulated during human evolution had opposing effects from each other.

    “This helps answer a longstanding question about why HARs evolved so quickly after being frozen for millions of years,” says Katie Pollard, PhD, director of the Gladstone Institute of Data Science and Biotechnology and lead author of the new study published today in Neuron. “An initial variation in a HAR might have turned up its activity too much, and then it needed to be turned down.”

    The findings, she says, have implications for understanding human evolution. In addition—because she and her team discovered that many HARs play roles in brain development—the study suggests that variations in human HARs could predispose people to psychiatric disease.

    “These results required cutting-edge machine learning tools to integrate dozens of novel datasets generated by our team, providing a new lens to examine the evolution of HAR variants,” says Sean Whalen, PhD, first author of the study and senior staff research scientist in Pollard’s lab.

    Enabled by Machine Learning

    Pollard discovered HARs in 2006 when comparing the human and chimpanzee genomes. While these stretches of DNA are nearly identical among all humans, they differ between humans and other mammals. Pollard’s lab went on to show that the vast majority of HARs are not genes, but enhancers— regulatory regions of the genome that control the activity of genes.

    More recently, Pollard’s group wanted to study how human HARs differ from chimpanzee HARs in their enhancer function. In the past, this would have required testing HARs one at a time in mice, using a system that stains tissues when a HAR is active.

    Instead, Whalen input hundreds of known human brain enhancers, and hundreds of other non-enhancer sequences, into a computer program so that it could identify patterns that predicted whether any given stretch of DNA was an enhancer. Then he used the model to predict that a third of HARs control brain development.

    “Basically, the computer was able to learn the signatures of brain enhancers,” says Whalen.

    Knowing that each HAR has multiple differences between humans and chimpanzees, Pollard and her team questioned how individual variants in a HAR impacted its enhancer strength. For instance, if eight nucleotides of DNA differed between a chimpanzee and human HAR, did all eight have the same effect, either making the enhancer stronger or weaker?

    “We’ve wondered for a long time if all the variants in HARs were required for it to function differently in humans, or if some changes were just hitchhiking along for the ride with more important ones,” says Pollard, who is also chief of the division of bioinformatics in the Department of Epidemiology and Biostatistics at UC San Francisco (UCSF), as well as a Chan Zuckerberg Biohub investigator.

    To test this, Whalen applied a second machine learning model, which was originally designed to determine if DNA differences from person to person affect enhancer activity. The computer predicted that 43 percent of HARs contain two or more variants with large opposing effects: some variants in a given HAR made it a stronger enhancer, while other changes made the HAR a weaker enhancer.

    This result surprised the team, who had expected that all changes would push the enhancer in the same direction, or that some “hitchhiker” changes would have no impact on the enhancer at all.

    Measuring HAR Strength

    To validate this compelling prediction, Pollard collaborated with the laboratories of Nadav Ahituv, PhD, and Alex Pollen, PhD, at UCSF. The researchers fused each HAR to a small DNA barcode. Each time a HAR was active, enhancing the expression of a gene, the barcode was transcribed into a piece of RNA. Then, the researchers used RNA sequencing technology to analyze how much of that barcode was present in any cell—indicating how active the HAR had been in that cell.

    “This method is much more quantitative because we have exact barcode counts instead of microscopy images,” says Ahituv. “It’s also much higher throughput; we can look at hundreds of HARs in a single experiment.”

    When the group carried out their lab experiments on over 700 HARs in precursors to human and chimpanzee brain cells, the data mimicked what the machine learning algorithms had predicted.

    “We might not have discovered human HAR variants with opposing effects at all if the machine learning model hadn’t produced these startling predictions,” said Pollard.

    Implications for Understanding Psychiatric Disease

    The idea that HAR variants played tug-of-war over enhancer levels fits in well with a theory that has already been proposed about human evolution: that the advanced cognition in our species is also what has given us psychiatric diseases.

    “What this kind of pattern indicates is something called compensatory evolution,” says Pollard. “A large change was made in an enhancer, but maybe it was too much and led to harmful side effects, so the change was tuned back down over time—that’s why we see opposing effects.”

    If initial changes to HARs led to increased cognition, perhaps subsequent compensatory changes helped tune back down the risk of psychiatric diseases, Pollard speculates. Her data, she adds, can’t directly prove or disprove that idea. But in the future, a better understanding of how HARs contribute to psychiatric disease could not only shed light on evolution, but on new treatments for these diseases.

    “We can never wind the clock back and know exactly what happened in evolution,” says Pollard. “But we can use all these scientific techniques to simulate what might have happened and identify which DNA changes are most likely to explain unique aspects of the human brain, including its propensity for psychiatric disease.”

    ###

    About the Study

    The paper “Machine learning dissection of human accelerated regions in primate neurodevelopment,” was published in the journal Neuron on January 13, 2023.

    Other authors are Kathleen Keough, Alex Williams, Md. Abu Hassan Samee, and Sean Thomas of Gladstone; Fumitaka Inoue, Hane Ryu, Tyler Fair, Eirene Markenscoff-Papadimitrious, Beatriz Alvarado, Orry Elor, Dianne Laboy Cintron, Erik Ullian, Arnold Kriegstein, and John Rubenstein of UC San Francisco; Martin Kircher, Beth Martin, and Jay Shendure of University of Washington; and Robert Krencik of Houston Methodist Research Institute.

    The work was supported by the Schmidt Futures Foundation and the National Institutes of Health (DP2MH122400-01, R35NS097305, FHG011569A, R01MH109907, U01MH116438, UM1HG009408, UM1HG011966, 2R01NS099099).

    About Gladstone Institutes

    To ensure our work does the greatest good, Gladstone Institutes focuses on conditions with profound medical, economic, and social impact—unsolved diseases. Gladstone is an independent, nonprofit life science research organization that uses visionary science and technology to overcome disease. It has an academic affiliation with the University of California, San Francisco.

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    Gladstone Institutes

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