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Tag: Psychology and Psychiatry

  • Ethiopian schools study suggests COVID has “ruptured” social skills of the world’s poorest children

    Ethiopian schools study suggests COVID has “ruptured” social skills of the world’s poorest children

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    Newswise — School closures during the COVID-19 pandemic have “severely ruptured” the social and emotional development of some of the world’s poorest children, as well as their academic progress, new evidence shows.

    In a study of over 2,000 primary school pupils in Ethiopia, researchers found that key aspects of children’s social and emotional development, such as their ability to make friends, not only stalled during the school closures, but probably deteriorated.

    Children who, prior to the pandemic, felt confident talking to others or got on well with peers were less likely to do so by 2021. Those who were already disadvantaged educationally – girls, the very poorest, and those from rural areas – seem to have been particularly badly affected.

    Both this research and a second, linked study of around 6,000 grade 1 and 4 primary school children, also found evidence of slowed academic progress. Children lost the equivalent of at least one third of an academic year in learning during lockdown – an estimate researchers describe as “conservative”. This appears to have widened an already significant attainment gap between disadvantaged pupils and the rest, and there is some evidence that this may be linked to the drop in social skills.

    Both studies were by academics from the University of Cambridge, UK and Addis Ababa University, Ethiopia.

    Professor Pauline Rose, Director of the Research in Equitable Access and Learning (REAL) Centre at the Faculty of Education, University of Cambridge, said: “COVID is having a long-term impact on children everywhere, but especially in lower-income countries. Education aid and government funding must focus on supporting both the academic and socio-emotional recovery of the most disadvantaged children first.”

    Professor Tassew Woldehanna, President of Addis Ababa University, said: “These  severe ruptures to children’s developmental and learning trajectories underline how much we need to think about the impact on social, and not just academic skills. Catch-up education must address the two together.”

    Both studies used data from the Research on Improving Systems of Education (RISE) programme in Ethiopia to compare primary education before the pandemic, in the academic year 2018/19, with the situation in 2020/21.

    In the first study, researchers compared the numeracy test scores of 2,700 Grade 4 pupils in June 2019 with their scores shortly after they returned to school, in January 2021. They also measured dropout rates. In addition, pupils completed the Children’s Self Report Social Skills scale, which asked how much they agreed or disagreed with statements such as “I feel confident talking to others”, “I make friends easily”, and “If I hurt someone, I say sorry”.

    The second study measured relative progress during the pandemic using the numeracy scores of two separate cohorts of Grade 1 and Grade 4 pupils. The first of these cohorts was from the pre-pandemic year; the other from 2020/21.

    The results suggest pupils made some academic progress during the closures, but at a slower than expected rate. The average foundational numeracy score of Grade 1 pupils in 2020/21 was 15 points behind the 2018/19 cohort; by the end of the year that gap had widened to 19 points. Similarly, Grade 4 students started 2020/21 10 points behind their predecessor cohort, and were 12 points adrift by the end. That difference amounted to roughly one third of a year’s progress. Similar patterns emerged from the study of children’s numeracy scores before and after the closures.

    Poorer children, and those from rural backgrounds, consistently performed worse academically. Dropout rates revealed similar issues: of the 2,700 children assessed in 2019 and 2021, more than one in 10 (11.3%) dropped out of school during the closures. These were disproportionately girls, or lower-achieving pupils, who tended to be from less wealthy or rural families.

    All pupils’ social skills declined during the closure period, regardless of gender or location. Fewer children agreed in 2021 with statements such as “Other people like me” or “I make friends easily”. The decline in positive responses differed by demographic, and was sharpest among those from rural settings. This may be because children from remote parts of the country experienced greater isolation during lockdown.

    The most striking evidence of a rupture in socio-emotional development was the lack of a predictive association between the 2019 and 2021 results. Pupils who felt confident talking to others before the pandemic, for example, had often changed their minds two years later.

    Researchers suggest that the negative impact on social and emotional development may be linked to the slowdown in academic attainment. Children who did better academically in 2021 tended to report stronger social skills. This association is not necessarily causal, but there is evidence that academic attainment improves children’s self-confidence and esteem, and that prosocial behaviours positively influence academic outcomes. It is therefore possible that during the school closures this potential reinforcement was reversed.

    Both reports echo previous research which suggests that lower-income countries such as Ethiopia need to invest in targeted programmes for girls, those from rural backgrounds, and the very poorest, if they are to prevent these children from being left behind. Alongside in-school catch-up programmes, action may be required to support those who are out of school. Ghana’s successful Complementary Basic Education initiative provides one model.

    In addition, the researchers urge education policy actors to integrate support for  social skills into both catch-up education and planning for future closures. “Social and emotional skills should be an explicit goal of the curriculum and other guidance,” Rose said. “Schools may also want to think about after-school clubs, safe spaces for girls, and ensuring that primary-age children stay with the same group of friends during the day. Initiatives like these will go some way towards rebuilding the prosocial skills the pandemic has eroded.”

    Ruptured School Trajectories is published in the journal, Longitudinal and Life Course Studies. Learning Losses during the COVID-19 Pandemic in Ethiopia, is available on the REAL Centre website.

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    University of Cambridge

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  • Fear of COVID-19 continues to impact adversely on psychological wellbeing

    Fear of COVID-19 continues to impact adversely on psychological wellbeing

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    Newswise — Research by psychologists from the School of Psychology at Swansea University found that people’s fear of COVID-19 has led to worsened mental health. The study, just published in the Journal of Health Psychology, also found that older participants and those from minority ethnic groups were most likely to experience COVID-19 fear.

    The researchers examined the impact of COVID-19 fear on key aspects of psychological wellbeing with an online survey of the same sample of participants at two different timepoints during the pandemic.

    The first timepoint took place in February 2021 when daily death rates and hospitalisations were at their highest during the pandemic (to date) and vaccination rates were low. At this point, COVID-19 fear predicted higher levels of anxiety, depression, worry, loneliness, sleep difficulties and problems coping with uncertainty

    The second timepoint took place in June 2021 when daily death rates and hospitalisations had dropped considerably, and many participants had received two vaccinations.  At this  second point, levels of COVID-19 fear had decreased; however, fear of the virus still predicted higher levels of worry, sleep difficulties and problems in dealing with uncertain situations.

    In this way, the impact of COVID-19 evolved, impacting different aspects of wellbeing among the same sample of participants.

    Dr Martyn Quigley, Lecturer in Psychology at Swansea University, who led the study, said:

    “This research demonstrates the significant toll of the pandemic on the psychological wellbeing of many people, especially at the most challenging times during the pandemic. What is particularly striking though is that COVID-19 fear continued to have an impact on people’s wellbeing when circumstances had appeared to considerably improve, thus demonstrating the long-term impact of the pandemic on wellbeing.”

    The research was conducted as part of a Welsh Government (Ser-Cymru) funded project examining the impact of COVID-19 on psychological wellbeing. In addition to conducting survey-based studies, the researchers have conducted online experiments adapted from tasks regularly used in the laboratory to provide behavioural performance markers of mental health coping as we emerge from the pandemic.

    END

    Notes to editors:

    The article entitled, “Longitudinal assessment of COVID-19 fear and psychological wellbeing in the United Kingdom”, can be accessed here: https://doi.org/10.1177/13591053221134848

    Swansea University is a world-class, research-led, dual campus university offering a first-class student experience and has one of the best employability rates of graduates in the UK. The University has the highest possible rating for teaching – the Gold rating in the Teaching Excellence Framework (TEF) in 2018 and was commended for its high proportions of students achieving consistently outstanding outcomes.

    Swansea climbed 14 places to 31st in the Guardian University Guide 2019, making us Wales’ top ranked university, with one of the best success rates of graduates gaining employment in the UK and the same overall satisfaction level as the Number 1 ranked university.

    The 2014 Research Excellence Framework (REF) 2014 results saw Swansea make the ‘biggest leap among research-intensive institutions’ in the UK (Times Higher Education, December 2014) and achieved its ambition to be a top 30 research University, soaring up the league table to 26th in the UK.

    The University is in the top 300 best universities in the world, ranked in the 251-300 group in The Times Higher Education World University rankings 2018.  Swansea University now has 23 main partners, awarding joint degrees and post-graduate qualifications.

    The University was established in 1920 and was the first campus university in the UK. It currently offers around 350 undergraduate courses and 350 postgraduate courses to circa 20,000 undergraduate and postgraduate students.  The University has ambitious expansion plans as it moves towards its centenary in 2020 and aims to continue to extend its global reach and realise its domestic and international potential.

    Swansea University is a registered charity. No.1138342. Visit www.swansea.ac.uk

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    Swansea University

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  • Caregivers’ coping strategies tied to anxiety, depression and quality of life

    Caregivers’ coping strategies tied to anxiety, depression and quality of life

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    Newswise — (Washington, Nov. 18, 2022) – November is Caregiver Awareness Month, and timely findings from a study published in Blood Advances suggest that, among caregivers of patients undergoing a stem cell transplant, how someone approaches coping can influence their levels of anxiety, depression, and poor quality of life (QOL) they experience. In particular, problem-solving and acceptance coping strategies seemed more helpful.

    “This study highlights that the psychological distress caregivers experience is real, and how caregivers cope with the challenges they face in supporting their loved one affects their level of distress and their quality of life. We also know from prior research that caregivers’ psychological well-being affects patient outcomes,” said Hermioni Amonoo, MD, of the Dana-Farber Cancer Institute and Carol C. Nadelson, MD, Distinguished Chair in Psychiatry, Brigham and Women’s Hospital in Boston, and the study’s principal investigator.

    Most stem cell transplant centers require people preparing to undergo a transplant to designate a primary caregiver – someone who will support them during the first 100 days after their transplant. In addition, before undergoing a stem-cell transplant for a blood cancer, most patients receive induction chemotherapy, which effectively wipes out their immune system, leaving them highly vulnerable to infection and other medical complications.

    Caregivers have many responsibilities, Dr. Amonoo said, including taking steps to protect patients from infection due to their highly immunocompromised state, supporting patients to properly take numerous medications every day, helping patients prepare meals that adhere to post-transplant guidelines, and coordinating communication between patients and their health care teams.

    “Our study underscores an urgent need for resources to help those caring for patients develop and use coping strategies that protect their mental health and quality of life and enable them to successfully fulfill this important role,” she said.

    Previous studies have shown that caregivers of patients with cancer experience distress, loneliness, fatigue, sleep disturbance, financial worry, and poor QOL, and that fatigue among caregivers of patients undergoing a stem cell transplant is associated with slower growth of healthy new blood cells and poorer sleep quality for the patient. Dr. Amonoo took this research a step further by specifically studying the effects of different types of coping on caregivers and their loved ones.

    “This is the largest study to date to examine caregiver coping strategies,” Dr. Amonoo said. “The whole field of caregiver research is very new,” she said. 

    Researchers in this field classify caregiver coping strategies into two broad categories called “avoidant” and “approach-oriented.” Avoidant coping strategies include denial of the reality of the situation, and self-blame, in which the caregiver blames themselves if the patient misses a medication dose or is late for an appointment. By contrast, approach-oriented coping strategies include active problem solving, finding sources of emotional support, and using “positive reframing” to think about their situation in a different way.                    

    For this study, Dr. Amonoo and her colleagues enrolled 170 primary caregivers of people with a blood cancer who were undergoing a stem cell transplant. A caregiver could be a spouse, relative, or friend whom the patient identified as their primary caregiver. Most caregivers were female (130, or 76.5%) and white (147, or 86.5%); their median age was 53. Shortly after the patient’s admission to the hospital for their stem cell transplant, caregivers completed questionnaires that asked about their use of different coping strategies, symptoms of anxiety or depression, and QOL. The researchers also looked at caregivers’ reliance on religious beliefs as a coping strategy.

    A significant number of caregivers reported high use of acceptance (55.9%), positive reframing (45.9%), and religious (44.1%) coping strategies. Caregivers who relied on approach-oriented coping strategies such as these (49.4%) had fewer symptoms of anxiety and depression and better QOL compared with those who relied on avoidant coping strategies (32.9%).

    “Strategies such as active problem-solving and positive reframing seemed to be more helpful for caregivers than strategies such as denial and self-blame,” Dr. Amonoo said. “In this study, we didn’t find an association between religious coping strategies and caregiver distress or QOL, although some previous smaller studies have found such an association.”

    “Coping strategies aren’t good or bad – you have to meet people where they are,” she added. “And caregivers can be taught to use coping strategies that may be more helpful and may enable them to feel less anxious, depressed, or overwhelmed. So if a caregiver is thinking, ‘My life will never be the same again,’ we can help them reframe that in a more positive way – for example, ‘I know there will be a lot of uncertainty as my loved one recovers from their stem cell transplant, but I’m not in this alone – I can talk to the care team when questions come up or when I feel inadequate about something I need to do.’”

    Dr. Amonoo said that her research group is working on developing a variety of interventions and resources for caregivers. “Our goal is to create resources that help caregivers be successful while also enabling them to take care of their own mental health,” she said.

    The study was funded by the National Cancer Institute and the Leukemia and Lymphoma Society.

    # # #

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    American Society of Hematology (ASH)

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  • Improvisation and creativity in professional jazz musicians

    Improvisation and creativity in professional jazz musicians

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    Newswise — World-renowned jazz musicians are often praised for their creative ingenuity. But how do they make up improvisations? And what makes artists’ solos  more enticing than those of less skilled players? These questions continue to puzzle not only jazz aficionados, but also psychological researchers. Two leading theories have dominated so far: Either musicians learn to master rules telling them what they can and cannot play – a sort of “secret language of jazz.” Or, each musician builds up a personal library of melodic patterns – “licks” – that they can draw upon and recombine in new and interesting ways. Over the years, musical scholars have collected many such volumes of “licks” for learners to practice. Yet, the fact that a certain combination of notes recurs many times is no proof of an underlying movement pattern stored in the brains of musicians—it could just be a sheer coincidence.

    The ‘library theory’ of jazz improvisation
    A new scientific study, just published in the journal Cognition, provides the first solid psychological evidence for the library theory of jazz improvisation. For the first time ever, researchers from Aarhus University and Georgia State University found that expert jazz musicians play certain note combinations with much more consistent timing and force than others. Regardless if these “licks” were played fast or slow, loud or soft, the relative rhythms and accents remained very similar. This strongly suggests that each player possesses a collection of patterns that are directly grounded in their own body and brain. Many jazz experts have called it their personal “vocabulary.” Interestingly, the new study found that these improvisation vocabularies vary between different players.

    Martin Norgaard, born and raised in Denmark, now Associate Professor of Music Education at Geogia State University in Atlanta comments further: “It is fascinating that expert jazz musicians store linked audio and motor representations in the brain – that is both the sound of licks and information about how to play them. As a jazz violinist myself, I often hear licks I want to play while improvising but the motor representation is not complete so the lick doesn’t come out right. Based on our research, that should happen less as expertise develops.”

    Stylistically appropriate and novel – hallmarks of creativity
    Using an advanced computer model, the researchers furthermore showed that “licks” tend to occur in relatively predictable contexts but simultaneously evoke greater surprise and uncertainty in the listener. This finding fits well with leading theories in psychology and neuroscience about human creativity and what makes certain types of music particularly enjoyable to listen to. Specifically, melodies in the personal vocabularies of jazz improvisers are typically both stylistically appropriate and novel—the two hallmarks of creativity according to scientists.

    “The fact that the solos of jazz experts evoke strong expectations in listeners and simultaneously surprise them might be exactly what makes these melodies so catchy and memorable. This may ultimately help us understand why some musicians become famous while others don’t,” said senior author Niels Chr. Hansen, Assistant Professor at Aarhus Institute of Advanced Studies at Aarhus University, Denmark.

    The research results – how did they do it?

    • The researchers analysed nearly 100,000 notes played on a MIDI keyboard by the artist-level jazz pianist Kevin Bales, during 11 live music gigs for audiences in the United States. This collection of solos was compared to recordings of 25 experienced jazz pianists taking part in a previous laboratory experiment.
    • For each recurring 5-note sequence, the durations of notes and the force with which they were played were compared across versions of the same pattern to find the set of licks that were played the most consistently across different tempi and loudness.
    • A computational model was trained on the Weimar Jazz Database consisting of more than 200,000 notes from 456 improvised songs by various jazz artists to estimate how much surprise and uncertainty each note in Kevin Bales’ improvised solos would evoke in an average jazz listener.

    Where can I find the scientific article?

    • Download: Until 18 December 2022, the article can be accessed freely via this link: https://authors.elsevier.com/c/1f-OF2Hx2pj8N
    • Citation: Norgaard, M., Bales, K., & Hansen, N.C. (2023). Linked auditory and motor patterns in the improvisation vocabulary of an artist-level jazz pianist. Cognition, 230. doi:10.1016/j.cognition.2022.105308

    Funding

    The study has received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement No 754513 and The Aarhus University Research Foundation. 

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    Aarhus University

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  • Is ayahuasca safe? New study tallies adverse events

    Is ayahuasca safe? New study tallies adverse events

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    Newswise — There is a high rate of adverse physical effects and challenging psychological effects from using the plant-based psychoactive ayahuasca, though they are generally not severe, according to a new study published this week in the open-access journal PLOS Global Public Health by Daniel Perkins of University of Melbourne, Australia, and colleagues.

    Ayahuasca is a South American psychoactive brewed drink used in traditional medicine and ceremony. Its contemporary use has been expanding throughout the world for mental health purposes and for spiritual and personal growth. Although clinical trials and observational studies have examined the potential benefits of ayahuasca, few have analyzed its adverse effects.

    In the new study, the researchers used data from an online Global Ayahuasca survey carried out between 2017 and 2019, involving 10,836 people from more than 50 countries who were at least 18 years old and had used ayahuasca at least once. Information on participants’ age, physical and mental health and history and context of ayahuasca use was collected.

    Overall, acute physical health adverse effects were reported by 69.9% of the sample, with the most common effects being vomiting and nausea (68.2% of participants), headache (17.8%) and abdominal pain (12.8%). Only 2.3% of participants reporting physical adverse events required medical attention for this issue. Among all participants, 55% also reported adverse mental health effects, including hearing or seeing things (28.5%), feeling disconnected or alone (21.0%), and having nightmares or disturbing thoughts (19.2%). However, of all respondents identifying these mental health effects, 87.6% believed they were completely or somewhat part of a positive growth process.

    The researchers also identified several factors that predispose people to the adverse physical events, including older age, having a physical health condition or substance use disorder, lifetime ayahuasca use and taking ayahuasca in a non-supervised context.

    The authors make the observation that ayahuasca has notable, although rarely severe, adverse effects according to the standards used for assessing prescription medicines. In that sense, they state that ayahuasca practices can hardly be assessed with the same parameters used for prescription medicines, since the myriad of its effects include challenging experiences that are intrinsic to the experience, some of which are considered as part of its healing process.

    The authors add: “Many are turning to ayahuasca due to disenchantment with conventional Western mental health treatments, however the disruptive power of this traditional medicine should not be underestimated, commonly resulting in mental health or emotional challenges during assimilation. While these are usually transitory and seen as part of a beneficial growth process, risks are greater for vulnerable individuals or when used in unsupportive contexts.”

    #####

    In your coverage please use this URL to provide access to the freely available article in PLOS Global Public Health: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000438

    Citation: Bouso JC, Andión Ó, Sarris JJ, Scheidegger M, Tófoli LF, Opaleye ES, et al. (2022) Adverse effects of ayahuasca: Results from the Global Ayahuasca Survey. PLOS Glob Public Health 2(11): e0000438. https://doi.org/10.1371/journal.pgph.0000438

    Author Countries: Spain, Brazil, Australia, Switzerland,

    Funding: The authors received no specific funding for this work.

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    PLOS

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  • Having good friendships may make for a healthier gut microbiome

    Having good friendships may make for a healthier gut microbiome

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    Newswise — Social connections are essential for good health and wellbeing in social animals, such as ourselves and other primates. There is also increasing evidence that the gut microbiome – through the so-called ‘gut-brain axis’ – plays a key role in our physical and mental health and that bacteria can be transmitted socially, for example through touch. So how does social connectedness translate into the composition and diversity of the gut microbiome? That’s the topic of a new study in Frontiers in Microbiology on rhesus macaques, Macaca mulatta.

    Lead author Dr Katerina Johnson, a research associate at the Department of Experimental Psychology and the Department of Psychiatry of the University of Oxford, said: “Here we show that more sociable monkeys have a higher abundance of beneficial gut bacteria, and a lower abundance of potentially disease-causing bacteria.”

    Monkey island

    The scientists focused on a single social group (with 22 males and 16 females between the ages of six and 20 years) of rhesus macaques on the island of Cayo Santiago, off the eastern coast of Puerto Rico. Macaques originally only lived in North Africa and Asia. But in 1938, a founder population of 409 rhesus macaques was moved from India to Cayo Santiago. Today, more than 1,000 macaques live on the 15.2 hectare island, divided into several social groups. They range and forage freely, although their diet gets supplemented daily with monkey chow. Researchers do behavioral observations on the monkeys each year.

    Between 2012 and 2013, the authors collected a total of 50 uncontaminated stool samples from this social group. As a measure of social connectedness, they used the time each monkey spent grooming or being groomed in 2012 and 2013, and his or her number of grooming partners.

    Social grooming

    Co-author Dr Karli Watson, from the Institute of Cognitive Science at the University of Colorado Boulder, explained: “Macaques are highly social animals and grooming is their main way of making and maintaining relationships, so grooming provides a good indicator of social interactions.”

    Johnson, Watson et al. analyzed DNA sequence data from the stool samples to measure the composition and diversity of the gut microbial community, and looked at the relationship with social connectivity. They also took into account sex, age, season, and rank within the group’s hierarchy. They focused on microbes that have been repeatedly shown in to be either more or less abundant in people or rodents with autism-like symptoms (commonly accompanied by social disconnection) or which are socially deprived.

    Sociable monkeys have more ‘good’ microbes

    “Engagement in social interactions was positively related to the abundance of certain gut microbes with beneficial immunological functions, and negatively related to the abundance of potentially pathogenic members of the microbiota,” said co-author Dr Philip Burnet, a professor from the Department of Psychiatry at the University of Oxford.

    For example, genera more abundant in the most sociable monkeys included Faecalibacterium and Prevotella. Conversely, the genus Streptococcus, which in humans can cause diseases such as strep throat and, pneumonia, was most abundant in less sociable monkeys.

    “It is particularly striking that we find a strong positive relationship between the abundance of the gut microbe Faecalibacterium and how sociable the animals are. Faecalibacterium is well known for its potent anti-inflammatory properties and is associated with good health,” said Johnson.

    Cause and effect?

    But what drives the relationship between social connectedness and gut microbiome composition? Distinguishing between cause and effect isn’t easy.

    “The relationship between social behavior and microbial abundances may be the direct result of social transmission of microbes, for example through grooming. It could also be an indirect effect, as monkeys with fewer friends may be more stressed, which then affects the abundance of these microbes. As well as behavior influencing the microbiome, we also know it is a reciprocal relationship, whereby the microbiome can in turn affect the brain and behavior,” said Johnson.

    Co-author Dr Robin Dunbar, a professor from the Department of Experimental Psychology at the University of Oxford, said: “As our society is increasingly substituting online interactions for real-life ones, these important research findings underline the fact that as primates, we evolved not only in a social world but a microbial one as well.”

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    Frontiers

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  • What happens to our dopamine system when we experience aversive events?

    What happens to our dopamine system when we experience aversive events?

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    Newswise — A new study at the Netherlands Institute for Neuroscience has examined how the dopamine system processes aversive unpleasant events.

    It is well known that the dopamine system plays a crucial role in motivation, learning and movement. One of the main functions of dopamine is to predict the occurrence of rewarding experiences and the availability of rewards in our environment. In this context, the dopamine system informs our brains about so-called ‘reward prediction errors’ – the difference between received and predicted rewards. Dopamine neurons become more active when a reward occurs unexpectedly or if it is bigger than expected, and they show depressed activity when we receive less reward than predicted. These error signals help us to learn from our mistakes and teach us how to achieve rewarding experiences.

    Rewarding versus aversive stimuli

    While a large number of studies has focused on the relationship between dopamine release and rewarding stimuli, few have looked at the effect of unpleasant and aversive stimuli on dopamine. Although the results of these few experiments have been inconsistent, it has become clear that aversive stimuli have an impact on the dopamine system. But there is an active debate among neuroscientists on what precise role dopamine neurons play in processing aversive stimuli: Does their activity change in response to aversive events? Do they predict aversive events? Do they encode an aversive prediction error?

    New findings on the role of dopamine in aversive events

    A new study at the Netherlands Institute for Neuroscience has examined how the dopamine system processes aversive events. The team around PhD student Jessica Goedhoop and group leader Ingo Willuhn exposed rats to white noise in combination with stimuli that predicted the white noise, while they measured the release of dopamine in the brain. White noise is a well-known example of an unpleasant auditory stimulus for rats.

    The researchers found that the release of dopamine gradually decreased during the exposure to white noise. Furthermore, after consistent presentation, stimuli that occurred a few seconds before white-noise exposure began to have the same depressing effect on dopamine neurons. However, in contrast to how it processes rewards, dopamine did not encode a prediction error for this aversive stimulus. Overall, this new study demonstrates that the dopamine system helps the brain to anticipate the occurrence and duration of unpleasant events, but without taking prediction errors into account.

    Group leader Ingo Willuhn: ‘This is a very thorough and systematic study that takes a lot of variables into account. The results give us a better understanding of the role of dopamine release in processing aversive events. There is a growing interest into the role of dopamine in aversion. We used a novel aversive stimulus that enabled to conduct a more thorough analysis of dopamine than previously possible.’

    Addictive drugs hijack and amplify dopamine signals and induce exaggerated, uncontrolled dopamine effects on neuronal plasticity. This study brings us closer to understanding the underlying mechanism behind this pathological phenomenon.

    Source: eLife

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    Netherlands Institute for Neuroscience

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  • Why eye contact is rare among people with autism

    Why eye contact is rare among people with autism

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    Newswise — New Haven, Conn. — A hallmark of autism spectrum disorder, ASD, is the reluctance to make eye contact with others in natural conditions. Although eye contact is a critically important part of everyday interactions, scientists have been limited in studying the neurological basis of live social interaction with eye-contact in ASD because of the inability to image the brains of two people simultaneously.

    However, using an innovative technology that enables imaging of two individuals during live and natural conditions, Yale researchers have identified specific brain areas in the dorsal parietal region of the brain associated with the social symptomatology of autism. The study, published Nov. 9 in the journal PLOS ONE, finds that these neural responses to live face and eye-contact may provide a biomarker for the diagnosis of ASD as well as provide a test of the efficacy of treatments for autism.

    “Our brains are hungry for information about other people, and we need to understand how these social mechanisms operate in the context of a real and interactive world in both typically developed individuals as well as individuals with ASD,” said co-corresponding author Joy Hirsch, Elizabeth Mears and House Jameson Professor of Psychiatry, Comparative Medicine, and of Neuroscience at Yale.

    The Yale team, led by Hirsch and James McPartland, Harris Professor at the Yale Child Study Center, analyzed brain activity during brief social interactions between pairs of adults — each including a typical participant and one with ASD — using functional near-infrared spectroscopy, a non-invasive optical neuroimaging method. Both participants were fitted with caps with many sensors that emitted light into the brain and also recorded changes in light signals with information about brain activity during face gaze and eye-to-eye contact.

    The investigators found that during eye contact, participants with ASD had significantly reduced activity in a brain region called the dorsal parietal cortex compared to those without ASD.  Further, the more severe the overall social symptoms of ASD as measured by ADOS (Autism Diagnostic Observation Schedule, 2nd Edition) scores, the less activity was observed in this brain region. Neural activity in these regions was synchronous between typical participants during real eye-to-eye contact but not during gaze at a video face. This typical increase in neural coupling was not observed in ASD, and is consistent with the difficulties in social interactions.

    “We now not only have a better understanding of the neurobiology of autism and social differences, but also of the underlying neural mechanisms that drive typical social connections,” Hirsch said.

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    Yale University

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  • The Early Bird May Just Get the Worm

    The Early Bird May Just Get the Worm

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    Newswise — Night owls may be looking forward to falling back into autumn standard time but a new study from the University of Ottawa has found Daylight Saving Time may also suit morning types just fine.

    Research from Dr. Stuart Fogel, a cognitive neuroscientist, professor at the University of Ottawa’s School of Psychology, and researcher at the Royal’s Institute for Mental Health Research, is shedding light into how the impact of a person’s daily rhythm and activity levels during both wake and sleep relate to human intelligence. Contrary to the adage “the early bird gets the worm,” previous work suggests that evening types, or “owls,” have superior verbal intelligence.

    Yet, “once you account for key factors including bedtime and age, we found the opposite to be true, that morning types tend to have superior verbal ability,” says Stuart Fogel, Director of the University of Ottawa Sleep Research Laboratory. “This outcome was surprising to us and signals this is much more complicated that anyone thought before.”

    Fogel’s team identified individual’s chronotype – their evening or morning tendencies – by monitoring biological rhythms and daily preferences. A person’s chronotype is related to when in the day they prefer to do demanding things, from intellectual pursuits to exercise.

    Young individuals are typically “evening types” while older individuals and those more regularly entrenched in their daily/nightly activities are likely “morning types”. The juxtaposition here is that morning is critical for young people, especially school aged children and adolescents, who have their schedules set by their morning-type parents and their routines. This might be doing youngsters a disservice.

    “A lot of school start times are not determined by our chronotypes but by parents and work-schedules, so school-aged kids pay the price of that because they are evening types forced to work on a morning type schedule,” says Fogel.

    “For example, math and science classes are normally scheduled early in the day because whatever morning tendencies they have will serve them well. But the AM is not when they are at their best due to their evening type tendencies. Ultimately, they are disadvantaged because the type of schedule imposed on them is basically fighting against their biological clock every day.”

    The study enlisted volunteers from a wide age range, who were rigorously screened to rule out sleep disorders and other confounding factors. They outfitted volunteers with a monitoring device to measure activity levels.

    Establishing the strength of a person’s rhythm, which drives intelligence, is key to understanding the results of this nuanced study, says Fogel, with a person’s age and actual bedtime proving important factors.

    “Our brain really craves regularity and for us to be optimal in our own rhythms is to stick to that schedule and not be constantly trying to catch up,” adds Fogel.

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    University of Ottawa

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  • Endocrine Society Condemns Florida Ban on Gender-Affirming Care

    Endocrine Society Condemns Florida Ban on Gender-Affirming Care

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    Newswise — WASHINGTON—The Endocrine Society rebukes the Florida Board of Medicine’s decision to ban gender-affirming care for transgender and gender-diverse teenagers.

    We call on the Florida Board of Medicine to reverse the ban and allow physicians to provide evidence-based care and protect the lives of minors.

    The Florida ban is blatantly discriminatory and contradicts medical evidence followed by the Endocrine Society, the American Academy of Pediatrics, the American Medical Association, the American Psychological Association, the Pediatric Endocrine Society and other mainstream medical organizations.

    When an individual’s gender identity is not respected and they cannot access medical care, it can result in higher psychological problem scores and can raise the person’s risk of committing suicide or other acts of self-harm. Research has found denying access to puberty-delaying medication and/or hormone therapy raises the risk of suicidal ideation and self-harm.

    According to the Endocrine Society’s globally recognized evidence-based Clinical Practice Guidelines, only reversible treatments to delay puberty are recommended for adolescents.  Puberty-delaying medication is safe, reversible, and the conservative approach that gives teenagers and their families more time to explore their options. The same treatment has been used for decades to treat precocious puberty.

    Teenagers who continue to demonstrate gender incongruence and who demonstrate the ability to provide informed consent can be offered gender-affirming hormone therapy, which is partially reversible. The Florida Medicaid ban prevents teenagers from accessing these important treatment options.

    Medical evidence, not politics, should inform treatment decisions. The Endocrine Society submitted comments earlier this year during the abbreviated public comment period on the Board’s guidance on “treating gender dysphoria for children and adolescents, yet the Florida Board of Health opted to rely on controversial research that is not recognized by the mainstream medical community in crafting its ban on gender-affirming care. Consequently, the state blocked transgender residents from receiving gender-affirming care through Medicaid coverage.

    Twenty states have proposed legislation to limit access to care during the 2022 legislative session, according to Freedom for All Americans. The Endocrine Society is alarmed that misinformation about medical care recommended for transgender and gender-diverse adolescents is fueling efforts to limit access to gender-affirming care. The move by the Florida Board of Health to ban gender-affirming care based on a political agenda rather than on science sets a dangerous precedent for all health care decisions.

    # # #

    Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

    The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

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  • Investigators Shed New Light on Brain Activity Related to Dissociative Symptoms

    Investigators Shed New Light on Brain Activity Related to Dissociative Symptoms

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    Newswise — Trauma can cause dissociative symptoms—such as having an out-of-body experience, or feeling emotionally numb—that may help an individual cope in the short term but can have negative impacts if the symptoms persist for a long period of time.

    In a new study recently published in Neuropsychopharmacology, a team led by investigators at McLean Hospital, the largest psychiatric affiliate of Harvard Medical School and a member of Mass General Brigham, has identified regions within brain networks that communicate with each other when people experience different types of dissociative symptoms.

    “Dissociation and severe dissociative disorders like dissociative identity disorder or ‘DID’ remain at best underappreciated and, at worst, frequently go undiagnosed or misdiagnosed,” said co-lead author Lauren A.M. Lebois, PhD, director of the Dissociative Disorders and Trauma Research Program.

    “The cost of this stigmatization and misdiagnosis is high—it has prevented people from accessing appropriate and effective treatment, caused prolonged suffering, and stunted research on dissociation. In addition, given that DID disproportionately affects women, gender disparity is an important issue in this context.”

    Lebois and her colleagues’ study included 91 women with and without histories of childhood trauma, current post-traumatic stress disorder, and with varied levels of dissociative symptoms. Participants completed a functional magnetic resonance imaging scan so that investigators could gain insight into their brain activity.

    “The novel methods we used to study brain connectivity are critical for understanding the role these network disturbances play in dissociative disorders,” said co-senior author Lisa D. Nickerson, PhD, director of the Applied Neuroimaging Statistics Lab at McLean Hospital.

    The scientists found that different dissociative symptoms were uniquely associated with connections of areas in brain networks that are responsible for cognition and emotion processes. “We found that dissociation common to post-traumatic stress disorder and dissociation central to DID are each linked to unique brain signatures,” said Lebois.

    The team hopes that a better understanding of the brain correlates of dissociation will help to rectify historical misunderstanding about dissociation and DID, destigmatize these experiences, and contribute to reducing gender-related health disparities.

    “We also hope it will increase awareness of dissociative symptoms—and that, ultimately, clinicians will be more likely to assess for and consider these symptoms, and to connect patients with timely and appropriate treatment,” said co–senior author Milissa Kaufman, MD, PhD, director of the Dissociative Disorders and Trauma Research Program.

    It is important to note the unique brain signatures of different dissociative symptoms may point to new therapies, the study authors said. “In the future, we could target brain activity related to dissociation as a treatment in and of itself,” said co-author Kerry J. Ressler, MD, PhD, chief scientific officer for McLean.

    Funding source: This research was supported by the Julia Kasparian Fund for Neuroscience Research (LAML, CP, MLK) and the National Institute of Mental Health K01MH118467 (LAML), R21MH112956 (MLK), and R01MH119227 (MLK). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

    ABOUT MCLEAN:
    McLean Hospital has a continuous commitment to put people first in patient care, innovation and discovery, and shared knowledge related to mental health. It is consistently named the #1 freestanding psychiatric hospital in the United States by U.S. News & World Report, and is #1 in America for psychiatric care in 2022-23. McLean Hospital is the largest psychiatric affiliate of Harvard Medical School and a member of Mass General Brigham. To stay up to date on McLean, follow us on Facebook, YouTube, and LinkedIn.

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  • Empathy for the Pain of the Conflicting Group Is Altered Across Generations in the Aftermath of a Genocide

    Empathy for the Pain of the Conflicting Group Is Altered Across Generations in the Aftermath of a Genocide

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    Newswise — Feeling empathy for others is deeply engrained into our biology, as seeing another individual in pain triggers an empathic response in the brain of the observer, which allows us to understand and feel what other feels. However, our capacity to feel empathy for the suffering of others is unfortunately not equal towards all human beings. “There are many individuals for which we have a natural, and potentially unconscious, reduction of empathy. This is notably the case when we witness the pain individuals that we do not recognize as part of our own group, and this can alter our prosociality towards them”, says lead author Prof. dr. Emilie Caspar (Université libre de Bruxelles, Ghent University) of a study published today in American Psychologist.

    Human conflicts can be extremely complex, but frequently arise when a group is perceived as not sharing a similar religion, culture, political opinion or ethnicity. In the aftermath of conflict, being able to understand and feel what the other group feel is critical for reaching reconciliation. But conflicts also enhance intergroup conflicts, as they accentuate resentment against the other group. Studying how intergroup biases evolve in war-torn societies is critical for understanding better the perpetuation of conflict.

    In Rwanda, citizens are exposed to a unique case of intergroup reconciliation and have to try to manage their intergroup biases caused by decades of ethnic conflicts and the Genocide against Tutsis. Between April 1994 and July 1994, more than one million of Tutsis and some moderate Hutus were mutilated and killed in a genocidal process. This dramatic event in the history of Rwanda seems unforgivable. However, Rwandan citizens have to learn to live together: perpetrators of the genocide were not invaders from another country; those who were killed died at the hands of their neighbors. Rwandan citizens thus cannot avoid the people they were in conflict with in the past, and have to be able to manage their emotions and behaviors toward their former aggressors or victims. “Can we expect individuals who have suffered such intense trauma, or who are descendants of the victims, to be able to resonate with the suffering of others and develop empathy toward them, especially if those others were their former aggressors?”, asks Emilie Caspar. That could nonetheless be crucial to ensure that a true reconciliation between groups is possible.

    She and her colleagues thus decided to travel across Rwanda to recruit former genocide perpetrators, survivors and their children thanks to the help of local associations. They installed their electroencephalograms and material in churches or bars in rural villages, any places that had at least some electric plugs. “That was of course an exceptional adventure, beyond the scientific aspect of the project. We were reaching a population that not a single neuroscientist approached before on the field, and we had to convince them to accept to wear a weird apparatus on their head to record their brain activity, while many of them never even saw a keyboard in their life”, adds Guillaume Pech, another author of the study.

    During the experiment, volunteers were asked to visualize pictures of different individuals, including for instance a former genocide perpetrator, a survivor or one of their offspring. In order to trigger an empathic reaction in the brain of the observer, the pictures also displayed painful stimulations or non-painful stimulations on those individuals. “With such procedure, it is classic to observe that the brain processes stimuli as more painful when the individual presented in considered as an ingroup member, compared to an outgroup member. And this is exactly what we observed in our sample from all volunteers no matter their group, even though the genocide happened 27 years ago at the moment of the testing”, says Emilie Caspar. This result suggests that it is difficult to get rid of intergroup biases in the aftermath of such tragedy.

    “But what was even more critical is that children from both former genocide perpetrators and survivors displayed the same intergroup bias as their parents, even though they did not experience the conflict themselves. This result might explain why some conflicts sometimes last over generations, as the children appear to have the same biases as their parents”, she adds.

    In the scientific literature, it is acknowledged that a trauma can be passed down generations, by social transmission through stories for instance, but also through genetic transmission. It would be important to determine exactly how intergroup biases are passed down generations to understand how to try to reduce them. The researchers of the study do not have the answer to this question but are now preparing a similar research project in Cambodia, where a genocide led by the Khmer Rouge killed about 2 million people between 1975 and 1979. This project will help to understand if intergroup biases are also observable two generations after the genocide or if they start to evaporate at some point.

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    Universite Libre de Bruxelles

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  • Outpatient Visits Are Critical to Success of Treating Opioid-Use Disorder, Researchers Find

    Outpatient Visits Are Critical to Success of Treating Opioid-Use Disorder, Researchers Find

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    Newswise — People with opioid-use disorder who enter treatment are at risk for relapse, overdose or death if they engage in less than two outpatient visits in their first month of care, according to a study coauthored by Rutgers researchers.

    The study, published in The American Journal of Psychiatry, examined the likelihood of patients continuing treatment for opioid-use disorder during their first month in care based on how often they engaged in outpatient visits or other professional services.

    “Engagement in outpatient visits or professional services appears to be a necessary condition for adequate care retention,” said study coauthor Stephen Crystal, the director of the Center for Health Services Research at the Rutgers Institute for Health, Health Care Policy and Aging Research and Distinguished Research Professor at the Rutgers School of Social Work. “Monitoring this engagement may help identify and address barriers and disparities in outcomes.”

    Starting an individual on medication for opioid-use disorder and then retaining them in professional care are two evidence-based interventions for reducing overdoses, according to the National Academies of Sciences, Engineering and Medicine. Researchers said patients participating in outpatient visits during treatment can be a measure of success for care retention, but there is a need to assess how this measure applies specifically to individuals with opioid-use disorder who are receiving medication, such as buprenorphine, as part of treatment.

    Using data reported between 2011 and 2019 from a multisite buprenorphine clinic throughout eight states, researchers examined the relationship between participating in outpatient visits and care retention in nearly 20,000 individuals. The patients were predominately male and non-Hispanic, which is broadly representative of people nationwide who are using buprenorphine for opioid use disorder treatment, according to prior research from study authors.

    Researchers found that nearly half of patients who participated in multiple outpatient visits in their first month of care remained in treatment for a minimum of six months, whereas 2.9 percent of patients who didn’t participate in multiple visits remained in treatment after six months.

    “This finding is critically meaningful and could guide intervention development to prioritize stabilization of high-risk patients early in treatment,” said Arthur Robin Williams, lead author of the study and an assistant professor at Columbia University Department of Psychiatry. “Without early engagement, the great majority of patients will be lost to relapse and possible death.”

    The study’s findings align with the priorities of organizations such as the Substance Abuse and Mental Health Services Administration, which support care coordination and peer navigation services early in treatment to help stabilize patients who otherwise might be lost to follow up. 

    “Many of these services are not currently reimbursable by payers, so insurance plans need to create bundled rates to be more innovative,” Williams said.

    More research is needed to identify patients at the greatest risk for overdose, said the researchers, adding that further research can demonstrate the importance of milestones in opioid-use treatment to develop care-performance measures.

     

    ABOUT RUTGERS INSTITUTE FOR HEALTH, HEALTH CARE POLICY AND AGING RESEARCH 

    Rutgers Institute for Health, Health Care Policy and Aging Research advances health and well-being through meaningful, rigorous and impactful research in the critical areas of behavioral health, health services, health disparities, health policy, health economics, pharmacoepidemiology, and aging research. 

    Since its 1985 founding, the Institute has become nationally renowned for interdisciplinary and translational research. The Institute’s 57,000 square foot facilities are home to six members elected to the National Academy of Medicine and 200 members representing over 30 schools, institutes, and units with adjunct members from 29 national and international universities.

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    Institute for Health, Health Care Policy and Aging Research at Rutgers University

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  • Medical Physicist Consults with Patients Can Help Reduce Anxiety and Increase Satisfaction with Radiation Care

    Medical Physicist Consults with Patients Can Help Reduce Anxiety and Increase Satisfaction with Radiation Care

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    Newswise — SAN ANTONIO, October 23, 2022 — Meeting with a medical physicist who can explain how radiation therapy is planned and delivered reduces patient anxiety and increases patient satisfaction throughout the treatment process, according to a new study published today in the International Journal of Radiation Oncology • Biology • Physics. Findings of the randomized, prospective phase III clinical trial also will be presented at the American Society for Radiation Oncology (ASTRO) Annual Meeting.

    “This study is a wake-up call for medical physicists that there are new ways we can add value to patient care,” said Todd F. Atwood, PhD, lead author of the study and an associate professor and Senior Associate Division Director of Transformational Clinical Physics at the University of California, San Diego. “It illustrates how care teams can partner more effectively with patients as they make their treatment decisions and navigate the radiation therapy process.”

    Medical physicists work with radiation oncologists to ensure complex treatment plans are properly tailored to each patient. They also develop and direct quality control programs to make sure treatments are delivered safely, including performing safety tests on the equipment used in a patient’s treatment.

    The new findings suggest that medical physicists also can supplement patient education and potentially improve patient outcomes by reducing patients’ treatment-related stress. “Patients increasingly want to be more involved with their care,” said Dr. Atwood. “They are looking for more information. Typically, they start by searching online, but what they’re finding is either non-specific or just too complex. They have unanswered questions, which often lead to confusion, stress and anxiety.”

    Prior studies have shown patient-related stress can negatively impact outcomes after radiation therapy. Dr. Atwood and his colleagues hope that by reducing stress and anxiety related to their treatment, this approach may also contribute to better patient outcomes.

    In this study, researchers randomized 66 patients seeking external beam radiation therapy into two treatment arms: one that would receive Physics Direct Patient Care (PDPC) prior to – and throughout – radiation treatment, and one that did not receive PDPC radiation therapy. Patients had different types of primary cancer, most commonly breast, gynecologic or prostate cancer, and most were receiving radiation therapy for the first time.

    In addition to traditional care, during which patients only discuss their treatment with their radiation oncologist, the PDPC group received two consultations prior to treatment with a medical physicist who explained the technical aspects of their care – how treatment is planned and delivered, how the radiation therapy technology works and “everything that goes into keeping them safe during treatment,” said Dr. Atwood. The medical physicist remained a resource for patients if additional questions arose at any point throughout the treatment process.

    Before interacting with patients, the five medical physicists participating in the study completed a patient communication training program that included radiation oncology specific lectures, role playing exercises, simulated patient interactions and analysis, and supervised physician-patient consults that included an analysis of those interactions.

    Changes in treatment-related anxiety, overall satisfaction with treatment and satisfaction with their understanding of the technical aspects of care were measured over the course of treatment using patient-reported questionnaires.

    Patients who received medical physicist consults had significant improvements in anxiety and both satisfaction metrics, compared to those who received treatment without the additional consults. Anxiety did not differ between the groups at baseline or following the simulation appointment, but it was lower, on average, for patients who got the medical physicist consults after the first treatment (30.2 vs. 37.6, on a 60-point inventory, p=0.027). By the end of treatment, however, the difference in average anxiety scores was no longer significant.

    To look more deeply at differences in anxiety between the groups, researchers looked specifically at the number of patients who reported high anxiety levels throughout treatment. While there were no significant differences in the proportion of high-anxiety patients at baseline, after the simulation appointment or after the first treatment, a substantial difference emerged by the end of treatment (12.5% vs. 38.9% reporting high anxiety, p=0.047).

    While the consults were beneficial for patients generally, Dr. Atwood said they may be particularly useful to patients who are more prone to anxiety. Among those receiving the additional consults, over the course of treatment, the percentage of patients reporting high anxiety levels dropped by more than half, from 31.3% to 12.5%.

    The greatest difference between the groups was seen in how satisfied patients were with their understanding of the technical aspects of their care. While there was no difference between the groups at baseline, the group that received an additional consult at the simulation appointment immediately expressed greater satisfaction with their technical understanding of care (6.2 vs. 5.1 on a 7-point scale, p=0.005). Technical satisfaction scores climbed for both groups throughout treatment, but they remained significantly higher for patients receiving additional consults, reaching 6.6 out of seven for that group, compared to 5.5 for the standard care group (p=0.002).

    Overall satisfaction was also significantly higher after the first treatment for patients who received physics consults (6.7 vs. 6.0 on a 7-point scale, p=0.014). While satisfaction rose for both groups following the first treatment, it remained significantly higher for the consult group until the end of treatment (6.9 vs. 6.2, p=0.001).

    Dr. Atwood said he was excited to see how long the benefits of supplemental consultation endured. “It has a lasting impact,” he said. “We’ve thought medical physics consults had great potential for years, but now we have a clearer understanding of how they positively impact the patient experience.”

    While other members of the care team could also be called upon to provide patients with a deeper understanding of their care, Dr. Atwood said he believes medical physicists were uniquely suited to the role because they were so familiar with the science driving the technology being used.

    “People don’t realize how personalized this therapy actually is. Medical physicists work behind the scenes to make sure this personalized treatment is both safe and effective. Our study indicates that there also can be a patient-facing role that will allow medical physicists to add more value to the patient experience” he said.

    ###

    Attribution to the American Society for Radiation Oncology (ASTRO) Annual Meeting is requested in all coverage.

    See this study presented:

    • Examining the impact of direct patient care for medical physicists: A randomized prospective phase III trial (Abstract 7)
    • News Briefing: Monday, October 24, 9:00 a.m. Central time. Details here.
    • Scientific Presentation: Clinical Trials Session, Sunday, October 23, 10:20 a.m. Central time, Henry B. Gonzalez Convention Center. Details here; email [email protected] for access.
    • Journal Citation: Atwood TF, Brown DW, Murphy JD, et al. Examining the Effect of Direct Patient Care for Medical Physicists: A Randomized Prospective Phase III Trial [published online ahead of print, 2022 Oct 24]. Int J Radiat Oncol Biol Phys. doi:10.1016/j.ijrobp.2022.05.014

     

    ABOUT ASTRO

    The American Society for Radiation Oncology (ASTRO) is the largest radiation oncology society in the world, with nearly 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. For information on radiation therapy, visit RTAnswers.org. To learn more about ASTRO, visit our website and media center and follow us on social media.

     

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  • UK policing: Psychological damage among officers heightened by bad working conditions – study

    UK policing: Psychological damage among officers heightened by bad working conditions – study

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    Newswise — High levels of trauma-related mental health disorders across UK police forces are partly the result of bad working conditions such as having too little time, sexual harassment, and dealing with difficult situations without support, according to a study led by the University of Cambridge. 

    However, officers who say they feel supported by colleagues, and have a sense of doing meaningful work, had around half the rates of a form of PTSD as the national average for policing staff.

    Researchers behind the study say their findings suggest that simple improvements to the working lives of police – scheduled time for support from peers and supervisors, for example – could dramatically reduce the level of psychiatric problems in UK forces. 

    Sociologists surveyed thousands of police personnel across the country in 2018 and found that 12% showed clinical symptoms of Complex Post-Traumatic Stress Disorder (C-PTSD), a chronic condition in which repeated trauma exposure causes social disconnection, feelings of worthlessness, and an inability to regulate emotions.

    Complex PTSD often leads to “burnout” and substance abuse. In fact, 90% of police workers in the original survey study ‘The Job, The Life’ had experienced trauma, and one in five of these reported symptoms of either PTSD or C-PTSD.

    Now, the same team of researchers have analysed survey data provided by 12,248 serving police officers to determine the working conditions and on-the-job situations with the strongest links to Complex PTSD. The latest findings are published in the journal Policing.

    Trauma detailed by officers with probable levels of Complex PTSD based on the survey screening included dealing with fatal car accidents, rapes, homicides, suicides – including of children – and drug overdoses.  

    Exposure to physical violence made little difference to rates of C-PTSD, nor did long working hours.

    However, officers who described it as “very difficult” to take time away from the job for personal or family matters had C-PTSD rates over 50% higher than the UK-wide average for police.  

    Those who described their relationship between work and personal life as “not fitting well at all”, some 15% of police officers in the study, had twice (24%) the average policing rates of C-PTSD.  

    One officer suffering with probable C-PTSD described how what you see “impacts on your life outside of work”, offering the example of cases involving dead children that “make you anxious about your own children’s wellbeing. To a degree you lose your innocence.”    

    Another C-PTSD sufferer said “it is a given and accepted” that the job means exposure to trauma, and describes the occupational health team in their force as “brilliant” but few in number. “They are only able to put ‘sticky plasters’ on, and send the officers back out,” the officer said.

    Police officers who described never having enough time to “get the job done” had almost double the rates of C-PTSD as the average across UK forces, 22% compared to 12%, as did officers who reported experiencing sexual harassment – whether from the public or colleagues*.    

    Officers who said they could never rely on the help and support of colleagues were most likely to suffer with Complex PTSD, with over 43% displaying symptoms, but such claims were relatively rare.

    One detective with C-PTSD symptoms recounted dealing with sexual abuse cases as the sole investigating officer. “Little or no support from management. Victims hanging all their hopes and pressures on me.”

    By contrast, C-PTSD rates were just 7% among those who said they could always rely on colleagues, and just 6% among those who say they regularly get a feeling of a job well done, with researchers claiming that a sense of meaningful work may provide a “protective effect” mentally.   

    “Our research shows that the debilitating psychological misery often caused by trauma exposure isn’t an inevitable part of the difficult job of policing, it is exacerbated by poor working conditions,” said Prof Brendan Burchell, lead author from Cambridge’s Department of Sociology.     

    The team also conducted analyses beyond individual officers to compare forces, revealing a strong link between “work intensity” – those forces with more officers reporting a lack of time to effectively police – and increased rates of Complex PTSD.

    Of 18 anonymised UK police forces, the one with the highest reported time constraints among officers had C-PTSD rates of 29%, well over double the average for the overall policing population.

    “Severe austerity cuts since 2010 leading to a marked reduction in police numbers without a decrease in the demands of the job inevitably creates more time pressure for remaining officers,” said Burchell.

    “Single-crewing, shift work and fewer resources mean that time for encouraging words between colleagues or space for officers to acknowledge their traumatic experiences are few and far between.”

    One officer with probable C-PTSD described being “single crewed” at a rural location for a year, with nearest support almost an hour away. Another spoke of going from a shift team of five to working alone. “My coping strategy of being around colleagues who had been to the same fatal accident or suicide was taken away from me.”  

    Cambridge co-author Dr Jessica Miller, who is also director of research for Police Care UK, the charity that funded the research, added: “The police forces reporting the best working conditions had much lower rates of PTSD. Modest investments to improve their working conditions could see significant reductions in psychological problems among police officers.”

     

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  • More than a quarter of U.S. adults say they’re so stressed they can’t function

    More than a quarter of U.S. adults say they’re so stressed they can’t function

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    Newswise — Americans are struggling with multiple external stressors that are out of their personal control, with 27% reporting that most days they are so stressed they cannot function, according to a poll conducted for the American Psychological Association.

    A majority of adults cited inflation (83%), violence and crime (75%), the current political climate (66%), and the racial climate (62%) as significant sources of stress.

    The nationwide survey, fielded by The Harris Poll on behalf of APA, revealed that 70% of adults reported they do not think people in the government care about them, and 64% said they felt their rights are under attack. Further, nearly half of adults (45%) said they do not feel protected by the laws in the United States. More than a third (38%) said the state of the nation has made them consider moving to a different country.

    More than three-quarters of adults (76%) said that the future of our nation is a significant source of stress in their lives, while 68% said this is the lowest point in our nation’s history that they can remember.

    Various disparities in stressors emerged among population subgroups. For example, 72% of the members of the LGBTQIA+ community reported feeling as if their rights are under attack, which is a higher proportion than non-LGBTQIA+ adults (64%). Younger adult women (ages 18 to 34) were more likely to report that most days their stress is completely overwhelming, in comparison with older women (62% vs. 48% 35-44; 27% 45-64; 9% 65+) and men ages 35 or older (62% vs. 48% 35-44; 21% 45-64; 8% 65+). Seventy-five percent of Black adults said that the racial climate in the U.S. is a significant source of stress, while 70% of Latino/a adults, 69% of Asian adults and 56% of white adults reported the same.

    Furthermore, Latinas were most likely, among racial/ethnic groups, to cite significant sources of stress related to violence, including violence and crime (89% Latinas; 80% Black women; 79% Asian women; 77% Latinos; 75% Black men; 73% white women; 72% white men; 70% Asian men), mass shootings (89% Latinas; 78% Latinos; 77% Black women; 77% Asian women; 73% white women; 71% Black men; 67% Asian men; 66% white men) and gun violence (87% Latinas; 83% Black women; 77% Asian women; 76% Latinos; 75% Black men; 69% white women; 68% white men; 63% Asian men).

    “It’s clear that the impacts of uncontrollable stressors are profound for most Americans, but psychological science shows us that there are effective ways to talk about and cope with this type of stress,” said Arthur C. Evans Jr., PhD, APA’s chief executive officer. “Focusing on accomplishing goals that are in our control can help prevent our minds from getting overwhelmed by the many uncertainties in life. From using our breathing to slow racing thoughts, to intentionally limiting our social media consumption, or exercising our right to vote, action can be extremely empowering.”

    Adults reported that stress has had an impact on their health; 76% of adults reported they had experienced at least one symptom in the last month as a result of stress – such as headache (38%), fatigue (35%), feeling nervous or anxious (34%) and feeling depressed or sad (33%). Seven in 10 adults (72%) experienced additional symptoms in the last month, including feeling overwhelmed (33%), experiencing changes in sleeping habits (32%), and/or worrying constantly (30%).

    “With so many people suffering health effects from these unrelenting external stressors, it’s important that all health care providers understand the research and offer their patients evidence-based techniques to reduce the effects of extreme stress and build their resilience,” said Evans.

    More information on the survey findings and how to handle stress related to uncertainty is available at www.stressinamerica.org.

    METHODOLOGY The 2022 Stress in America™ survey was conducted online within the United States by The Harris Poll on behalf of the APA between Aug. 18 and Sept. 2, 2022, among 3,192 adults age 18+ who reside in the U.S. Interviews were conducted in English and Spanish.

    Data are weighted where necessary to reflect their proportions in the population based on the 2021 Current Population Survey (CPS) by the U.S. Census Bureau. Weighting variables included age by gender, race/ethnicity, education, region, household income and time spent online. Latino/a adults were also weighted for acculturation, taking into account respondents’ household language as well as their ability to read and speak in English and Spanish. Country of origin (U.S./non-U.S.) was also included for Latino/a and Asian subgroups. Weighting variables for Gen Z adults (ages 18 to 25) included education, age by gender, race/ethnicity, region, household income and size of household, based on the 2021 CPS.

    Propensity score weighting was used to adjust for respondents’ propensity to be online. A propensity score allows researchers to adjust for attitudinal and behavioral differences between those who are online versus those who are not, those who join online panels versus those who do not, and those who responded to this survey versus those who did not.

    Respondents for this survey were selected from among those who have agreed to participate in Harris’s surveys. The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data is accurate to within + 2.9 percentage points using a 95% confidence level. This credible interval will be wider among subsets of the surveyed population of interest.

    All sample surveys and polls, whether or not they use probability sampling, are subject to other multiple sources of error, which are most often not possible to quantify or estimate, including but not limited to coverage error, error associated with nonresponse, error associated with question wording and response options, and post-survey weighting and adjustments.

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    American Psychological Association (APA)

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  • Statewide pandemic restrictions not related to psychological distress

    Statewide pandemic restrictions not related to psychological distress

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    Newswise — Despite concerns that stay-at-home orders and other government efforts to stem the spread of COVID-19 at the start of the pandemic would cause lasting harm to people’s mental health, research published by the American Psychological Association found that state restrictions in the first six months of the pandemic were not related to worse mental health.

    Instead, people with personal exposure to the virus and those who consumed several hours of COVID-19-related media a day were the most likely to experience distress, loneliness and symptoms of traumatic stress.

    The findings were published in the journal Health Psychology.

    “For the past several decades, our team has been examining the psychological impact of large-scale disasters on the population. In February 2020, we realized that the novel coronavirus, as it was called at the time, was likely to have an effect on the U.S. population in the months to come,” said senior author Roxane Cohen Silver, PhD, a distinguished professor of psychological science, medicine and public health at the University of California Irvine. “We were particularly interested in the potential negative mental health effects of the associated restrictions placed on individuals throughout the pandemic, despite their potential for minimizing the spread of illness.”

    The researchers surveyed a nationally representative sample of more than 6,500 participants at the start of the pandemic from March 18 to April 18, 2020, then surveyed almost 5,600 of the same participants approximately six months later from Sept. 26 to Oct. 16 to measure how their mental health and exposure to the virus changed over the course of the pandemic.

    Respondents answered questions about symptoms of distress, loneliness and traumatic stress (acute and post-traumatic stress) they experienced in the prior week; whether they had contracted COVID-19; how many people they knew who had contacted the virus or died because of COVID-19; and how many hours on average they spent daily over the past week consuming pandemic-related news on traditional media, online news sources and social media platforms. The researchers then compared their responses with data about the spread of COVID-19 and government mitigation efforts, such as school closures and stay-at-home orders in each respondent’s state.

    Researchers found that, overall, participants experienced more loneliness and symptoms of global distress, such as depression and anxiety, over the course of the six months, but their distress was not significantly related to state-level restrictions. Instead, personal experiences with COVID (degree of illness, losses), along with the amount of media about the pandemic to which individuals were exposed, were stronger predictors of psychological symptoms than state-level restrictions (mask mandates, closures, etc.) or case rates or death rates.

    Participants who responded that they had contracted COVID-19 in the first six months of the pandemic were the most likely to report poor mental health. Knowing someone who died because of COVID-19 or someone who had contracted COVID-19 were also significantly related to distress, loneliness, and symptoms of traumatic stress, according to Rebecca Thompson, PhD, the report’s first author and postdoctoral scholar at UC Irvine.

    “Because a strong predictor of distress in our study was personal bereavement – knowing someone who had been very sick or died was far more stressful than the presence of state-level restrictions – future waves of COVID-19 and other potential pandemics should be met by targeted interventions to prevent loss of life,” Thompson said. “Given this work, we would likely expect similar distress responses in future pandemics, highlighting the importance of public health initiatives to curb the spread of illness in our communities.”

    Greater hours of exposure to pandemic-related media coverage was also significantly related to increased symptoms of distress over time.

    “For the first year of the pandemic, it was all bad news all the time,” Silver said. “Repeated exposure to that content was unlikely to have psychological benefits.”

    In the case of future disasters or traumatic events, Silver recommends that individuals monitor the degree to which they immerse themselves in bad news (e.g., avoid “doomscrolling”) and consider specific times to check the news throughout the day.

    “One can stay informed without becoming overwhelmed with a constant onslaught of bad news,” said Silver.

    Article: “Psychological Responses to U.S. Statewide Restrictions and COVID-19 Exposures: A Longitudinal Study,” by Rebecca R. Thompson, PhD, Nickolas M. Jones, PhD, Apphia M. Freeman, BA, E. Alison Holman, PhD, Dana Rose Garfin, PhD, and Roxane Cohen Silver, PhD, University of California Irvine. Health Psychology, published Oct. 17, 2022.

    Contact: Roxane Cohen Silver, PhD, can be contacted at [email protected].

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  • Viral infections are less frequent but more severe in people with Down syndrome due to oscillating immune response

    Viral infections are less frequent but more severe in people with Down syndrome due to oscillating immune response

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    Newswise — Individuals with Down syndrome have less-frequent viral infections, but when present, these infections lead to more severe disease. New findings publishing on October 14 in the journal Immunity show that this is caused by increased expression of an antiviral cytokine type I interferon (IFN-I), which is partially coded for by chromosome 21. Elevated IFN-I levels lead to hyperactivity of the immune response initially, but the body overcorrects for this to reduce inflammation, leading to increased vulnerability later in the viral attack.

    “Usually too much inflammation means autoimmune disease, and immune suppression usually means susceptibility to infections,” says senior study author Dusan Bogunovic of the Icahn School of Medicine at Mount Sinai. “What is unusual is that individuals with Down syndrome are both inflamed and immunosuppressed, a paradox of sorts. Here, we discovered how this is possible.”

    Down syndrome is typically caused by triplication of chromosome 21. This syndrome affects multiple organ systems, causing a mixed clinical presentation that includes intellectual disability, developmental delays, congenital heart and gastrointestinal abnormalities, and Alzheimer’s disease in older individuals.

    Recently, it has become clear that atypical antiviral responses are another important feature of Down syndrome. Increased rates of hospitalization of people with Down syndrome have been documented for influenza A virus, respiratory syncytial virus, and severe acute respiratory syndrome due to coronavirus (SARS-CoV-2) infections.

    While people with Down syndrome show clear signs of immune disturbance, it has yet to be elucidated how a supernumerary chromosome 21 leads to dysregulation of viral defenses. To address this knowledge gap, the researchers compared fibroblasts and white blood cells derived from individuals with and without Down syndrome, at both the mRNA and protein levels. They focused on the potent antiviral cytokine IFN-I receptor subunits IFNAR1 and IFNAR2, which are located on chromosome 21.

    The researchers found that increased IFNAR2 expression was sufficient for the hypersensitivity to IFN-I observed in Down syndrome, independent of trisomy 21. But subsequently, the hyper-active IFN-I signaling cascade triggered excessive negative feedback via a protein called USP18, which is a potent IFNAR negative regulator. This process, in turn, suppressed further responses to IFN-I and antiviral responses. Taken together, the findings unveil oscillations of hyper- and hypo-responses to IFN-I in Down syndrome, predisposing to both lower incidence of viral disease and increased infection-related morbidity and mortality.

    “We have a lot more to do to completely understand the complexities of the immune system in Down syndrome,” says first author Louise Malle of the Icahn School of Medicine at Mount Sinai. “We have here, in part, explained the susceptibility to severe viral disease, but this is only the tip of the iceberg.”

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  • New insights into how serotonin regulates behavior

    New insights into how serotonin regulates behavior

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    Newswise — Ithaca, NY – Rates of anxiety and depression have been increasing around the world for decades, a trend that has been sharply exacerbated by the COVID-19 pandemic. New research led by the Boyce Thompson Institute’s Frank Schroeder could ultimately lead to new therapeutics to help relieve this global mental health burden.

    First discovered in the 1930s, serotonin is a neurotransmitter produced in many animals that mediates myriad behaviors, such as feeding, sleep, mood and cognition. Drugs that alter serotonin levels are the main weapon to treat psychological conditions like anxiety and depression, as well as eating disorders.

    As a simple model for neurobiology research, the microscopic roundworm Caenorhabditis elegans has been used extensively to study serotonin’s role in regulating behavior and food intake. For many years, researchers thought that serotonin was made in C. elegans by one specific molecular pathway, and that serotonin was then quickly degraded. Schroeder’s team and colleagues at Columbia University now demonstrated that both of those assumptions were not quite correct.

    “We discovered a second, parallel biosynthetic pathway that accounts for about half of the total serotonin produced in our model system,” said Schroeder.

    The findings are described in a paper published in Nature Chemical Biology on October 10.

    The work began about three years ago, when the researchers unexpectedly discovered an enzyme that converts serotonin into derivative compounds.

    “Most people in the field thought serotonin is made and then quickly broken down, but we found that, instead, it is used as a building block for other compounds that are responsible for some of serotonin’s activity,” explained Schroeder. “So, we decided to start at the beginning and see how serotonin is made, and once it is made then how is it converted into these new molecules.”

    Jingfang Yu, a graduate student in Schroeder’s lab and first author on the paper, further showed that the new serotonin derivatives affect feeding behavior.

    “When the worms lack endogenous serotonin, they tend to move quickly across the bacteria food lawn on an agar plate, and turn infrequently to explore the food,” Yu said. “We found this behavior can be alleviated by treating the worms with serotonin derivatives, suggesting these newly identified compounds contribute to effects previously attributed to serotonin.”

    The worm C. elegans is an excellent model for studying serotonin because the compound’s molecular signaling pathways are highly conserved across species, including in humans. For example, the researchers showed that in C. elegans a large portion of serotonin is made in the gut, which is also the case in humans.

    Schroeder said there are hints that human serotonin is converted into metabolites similar to the ones identified in C. elegans.

    “This research opens up the door for many more avenues of research in humans,” said Schroeder, who is also a professor in the Department of Chemistry and Chemical Biology in the college of Arts and Sciences at Cornell University.

    “Are the analogous metabolites important in humans? What is the role of one manufacturing pathway versus the other? How are these manufacturing pathways and metabolites important for human behaviors, like mental health and feeding behaviors?” he asked.

    The researchers are currently exploring how the new serotonin derivatives affect behavior in C. elegans and whether similar serotonin metabolites exist in humans.

    About Boyce Thompson Institute:

    Opened in 1924, Boyce Thompson Institute is a premier life sciences research institution located in Ithaca, New York. BTI scientists conduct investigations into fundamental plant and life sciences research with the goals of increasing food security, improving environmental sustainability in agriculture, and making basic discoveries that will enhance human health. Throughout this work, BTI is committed to inspiring and educating students and to providing advanced training for the next generation of scientists. BTI is an independent nonprofit research institute that is also affiliated with Cornell University. For more information, please visit BTIscience.org.

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  • Experiencing symptoms of COVID-19 associated with poorer mental health

    Experiencing symptoms of COVID-19 associated with poorer mental health

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    Newswise — Having symptoms of COVID-19 has been associated with worse mental health and lower life satisfaction.

    The study, which is part of the COVID-19 Longitudinal Health and Wellbeing National Core Study, is published today in The Lancet Psychiatry. The study is led by researchers from King’s College London and University College London in collaboration with several UK institutions. The study looked at the impact of COVID-19 infection on subsequent mental health and wellbeing.

    Data was taken from 11 longitudinal studies between April 2020 and April 2021, in which there were 54,442 participants with and without self-reported COVID-19.

    Researchers found that rises in psychological distress, depression, anxiety, and lower life satisfaction were associated with prior self-reported COVID-19. The associations with poorer mental health did not lessen over time after infection, highlighting the potential enduring impacts of the disease and the need for a longer follow-up process from healthcare providers. 

    Self-reported COVID-19 was consistently associated with psychological distress, regardless of whether people tested positive for antibodies to the virus. These effects of infection were felt similarly in different groups of gender, ethnicity and socio-economic circumstances.

    The study suggests that the infection of COVID-19 might impact mental health most in older people as people with self-reported infection aged 50 years and older showed a stronger association with poorer mental health. This might reflect that older people are more likely to experience more severe COVID-19 symptoms, greater worry around infection, and increased risk of blood vessel (microvascular) or brain (neurological) changes after infection. This contrasts to the effect of the pandemic overall on mental health, where previous studies have shown that women and adults aged 25-44 have had the greatest adverse impacts.

    Joint first author Dr Ellen Thompson from King’s College London said: “These findings suggest that there were prolonged mental health consequences of COVID-19 infection for some people at the beginning of this pandemic. Understanding why this is the case will be key to finding treatment strategies for those affected as well as preventing such effects in future pandemic waves.”

    Senior author Prof Praveetha Patalay from University College London said: “This study brings together many of the UK’s longitudinal studies to provide a comprehensive overview of the impacts of COVID-19 infection on population mental health. Compared to most studies to-date that have focussed on more severe and hospitalised cases, this study demonstrates the impact of infection during a pandemic on overall population mental health and wellbeing.”

     

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    King’s College London

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