Testing hypotheses about the harm that capitalism causes to the mind and brain: a theoretical framework for neuroscience research.

In this paper, we will attempt to outline the key ideas of a theoretical framework for neuroscience research that reflects critically on the neoliberal capitalist context. We argue that neuroscience can and should illuminate the effects of neoliberal capitalism on the brains and minds of the population living under such socioeconomic systems. Firstly, we review the available empirical research indicating that the socio-economic environment is harmful to minds and brains. We, then, describe the effects of the capitalist context on neuroscience itself by presenting how it has been influenced historically. In order to set out a theoretical framework that can generate neuroscientific hypotheses with regards to the effects of the capitalist context on brains and minds, we suggest a categorization of the effects, namely deprivation, isolation and intersectional effects. We also argue in favor of a neurodiversity perspective [as opposed to the dominant model of conceptualizing neural (mal-)functioning] and for a perspective that takes into account brain plasticity and potential for change and adaptation. Lastly, we discuss the specific needs for future research as well as a frame for post-capitalist research.

A Reduced Self-Positive Belief Underpins Greater Sensitivity to Negative Evaluation in Socially Anxious Individuals.

Positive self-beliefs are important for well-being, and are influenced by how others evaluate us during social interactions. Mechanistic accounts of self-beliefs have mostly relied on associative learning models. These account for choice behaviour but not for the explicit beliefs that trouble socially anxious patients. Neither do they speak to self-schemas, which underpin vulnerability according to psychological research. Here, we compared belief-based and associative computational models of social-evaluation, in individuals that varied in fear of negative evaluation (FNE), a core symptom of social anxiety. We used a novel analytic approach, 'clinically informed model-fitting', to determine the influence of FNE symptom scores on model parameters. We found that high-FNE participants learn more easily from negative feedback about themselves, manifesting in greater self-negative learning rates. Crucially, we provide evidence that this bias is underpinned by an overall reduced belief about self-positive attributes. The study population could be characterized equally well by belief-based or associative models, however large individual differences in model likelihood indicated that some individuals relied more on an associative (model-free), while others more on a belief-guided strategy. Our findings have therapeutic importance, as positive belief activation may be used to specifically modulate learning. AUTHOR SUMMARY: Understanding how we form and maintain positive self-beliefs is crucial to understanding how things go awry in disorders such as social anxiety. The loss of positive self-belief in social anxiety, especially in inter-personal contexts, is thought to be related to how we integrate evaluative information that we receive from others. We frame this social information integration as a learning problem and ask how people learn whether someone approves of them or not. We thus elucidate why the decrease in positive evaluations manifests only for the self, but not for an unknown other, given the same information. We investigated the mechanics of this learning using a novel computational modelling approach, comparing models that treat the learning process as series of stimulusresponse associations with models that treat learning as updating of beliefs about the self (or another). We show that both models characterise the process well and that individuals higher in symptoms of social anxiety learn more from negative information specifically about the self. Crucially, we provide evidence that this originates from a reduction in the amount of positive attributes that are activated when the individual is placed in a social evaluative context.

Deaths of young people living in residential aged care: a national population-based descriptive epidemiological analysis of cases notified to Australian coroners.

AIM: This study provides a descriptive epidemiological analysis stratified by age of deaths reported to Australian Coroners of residential aged care facility residents aged under 65 years. METHOD: A national population-based retrospective analysis was conducted of deaths of Australian residential aged care facility residents reported to Australian Coroners between 2000 and 2013. Descriptive statistics compared adult residents categorised using age by factors relating to the individual, incident and death investigation. RESULTS: Of the 21,736 deaths of residential aged care facilities residents aged over 20 years reported to Australian Coroners, 782 (3.6%) were of residents aged 20-64 years. Natural cause deaths occurred at similar rates irrespective of age. Intentional external cause deaths were higher in residents aged 20-64 years (5.3% vs. 16.0%; OR 3.43, 95% CI 2.0-5.9; p < 0.001), with suicide rates three times that of the over 65 years group (13.2% vs. 4.1%; OR 0.28, 95% CI 0.16-0.51; p < 0.001). External cause deaths from choking and falls were most common in the younger and older groups respectively. CONCLUSIONS: More is required to prevent external cause deaths in young residential care facility residents.IMPLICATIONS FOR REHABILITATIONOne in seven (14.1%) deaths of people aged 20-64 years in residential aged care facilities are premature and potentially avoidable. The more common external causes of death include suicide, choking and falls.The prevalence and causes of preventable deaths in this study provide a basis for prompting and developing more specific prevention policies and practices to reduce harm for young people in residential aged care. Specifically, addressing loneliness would improve social inclusion, mental health and suicide risk. Better management of progressive neurological conditions with multidisciplinary team and re-ablement programs would reduce risk of choking and falls.Improving outcomes for young people in residential aged care requires a co-ordinated, multisector approach comprising relevant government departments, aged care providers, researchers and clinicians.Effective planning requires more information about the cause and nature of deaths, and due to the small event counts, this would ideally involve an international collaboration.

Suicide-related over-the-counter analgesic exposures reported to United States poison control centers, 2000-2018.

PURPOSE: To investigate suicide-related over-the-counter (OTC) analgesic medication exposures among individuals ≥6 years old reported to United States (US) poison control centers. METHODS: Data from the National Poison Data System for the years 2000-2018 were retrospectively analyzed. RESULTS: From 2000 to 2018, US poison control centers recorded 549 807 suicide-related cases involving OTC analgesics, including 327 781 cases (59.6%) admitted to the hospital and 1745 deaths (0.3%). Most cases involved a single substance (67.5%) and occurred among females (72.7%) and individuals 6-19 years old (49.7%). Overall, the rate of exposures increased significantly by 33.5% from 2000 to 2018, primarily driven by the increasing exposure rate among 6- to 19-year-old females. From 2000 to 2018, exposure rates for acetaminophen and ibuprofen increased, while that for acetylsalicylic acid decreased. Additionally, the proportion of cases resulting in a serious medical outcome or healthcare facility admission increased for all types of OTC analgesics. Acetaminophen and acetylsalicylic acid accounted for 48.0% and 18.5% of cases, respectively, and 64.5% and 32.6% of deaths, respectively. Both acetaminophen and acetylsalicylic acid had greater odds of healthcare facility admission (ORs 2.56 and 2.63, respectively) and serious medical outcomes (ORs 2.54 and 4.90, respectively) compared with ibuprofen. CONCLUSIONS: The rate of suicide-related OTC analgesic cases is increasing. Acetaminophen and acetylsalicylic acid cases are associated with greater morbidity and mortality. Prevention efforts should include implementing unit-dose packaging requirements and restrictions on package sizes and purchase quantities for acetaminophen and acetylsalicylic acid products to reduce access to large quantities of these analgesics.

Locus coeruleus integrity in old age is selectively related to memories linked with salient negative events.

The locus coeruleus (LC) is the principal origin of noradrenaline in the brain. LC integrity varies considerably across healthy older individuals, and is suggested to contribute to altered cognitive functions in aging. Here we test this hypothesis using an incidental memory task that is known to be susceptible to noradrenergic modulation. We used MRI neuromelanin (NM) imaging to assess LC structural integrity and pupillometry as a putative index of LC activation in both younger and older adults. We show that older adults with reduced structural LC integrity show poorer subsequent memory. This effect is more pronounced for emotionally negative events, in accord with a greater role for noradrenergic modulation in encoding salient or aversive events. In addition, we found that salient stimuli led to greater pupil diameters, consistent with increased LC activation during the encoding of such events. Our study presents novel evidence that a decrement in noradrenergic modulation impacts on specific components of cognition in healthy older adults. The findings provide a strong motivation for further investigation of the effects of altered LC integrity in pathological aging.

Emotional arousal and recognition memory are differentially reflected in pupil diameter responses during emotional memory for negative events in younger and older adults.

A better memory for negative emotional events is often attributed to a conjoint impact of increased arousal and noradrenergic modulation (NA). A decline in NA during aging is well documented but its impact on memory function during aging is unclear. Using pupil diameter (PD) as a proxy for NA, we examined age differences in memory for negative events in younger (18-30 years) and older (62-83 years) adults based on a segregation of early arousal to negative events, and later retrieval-related PD responses. In keeping with the hypothesis of reduced age-related NA influences, older adults showed attenuated induced PD responses to negative emotional events. The findings highlight a likely contribution of NA to negative emotional memory, mediated via arousal that may be compromised with aging.