Relation among, trait anxiety, intolerance to uncertainty and early maltreatment experiences on fear discrimination learning and avoidance generalization online task.

BACKGROUND AND OBJECTIVES: Early aversive experiences, which have been associated with elevated anxiety and intolerance of uncertainty (IUS), may contribute negatively to fear conditioning learning. The aim of the present study was to analyze the relation among individual differences in childhood maltreatment experiences, trait anxiety, and IUS in adulthood; and to determine how these variables could affect fear learning discrimination and avoidance generalization. METHODS: We adapted an avoidance procedure in an online fear learning task. Two pictures of different lamp colors (CS+) were first associated with two aversive images (US), while a third color was not (CS-). Next, clicking a button during one CS + could effectively avoid the US (CS + av), but not during the other (CS + unav). Finally, avoidance generalization was tested to lamp colors that were between CS- and CS + av (safety dimension) and CS + av and CS + unav (avoidability dimension). With a sample of 67 participants, we measured ratings of relief, expectancy, and anxiety, as well as button presses and individual differences (STAI, IUS and MAES). RESULTS: Aversive early experiences were positively related to trait anxiety and intolerance of uncertainty. The results of the task further suggested that maltreatment experience contributes to be more attentive to aversive signals, which could be implicated in leading to difficulties in discrimination learning. LIMITATIONS: Online experiments implies some loss of control over subjects and environment that can threaten internal validity. Likewise, the commitment of participants may be low. CONCLUSIONS: Results suggest that early aversive experience and anxiety could contribute to the development of IUS, which likely contributes to the development of avoidance behavior.

Population attributable fraction of modifiable risk factors for dementia in Chile.

INTRODUCTION: Projected dementia incidence in Latin America and the Caribbean for the next decades is overwhelming. Access to local data, stratified by sex, is imperative for planning precise dementia-prevention strategies. METHODS: We analyzed the individual and overall weighted population attributable fraction (PAF) of nine modifiable risk factors for dementia, in dementia-free subjects ≥45-years-old, using the 2016-2017 Chilean National Health Survey. RESULTS: The overall weighted PAF for modifiable risk factors was 45.8% (42.2% to 49.3%). Variables with the highest PAF were lower education, high blood pressure, hearing loss, and obesity. Women showed a greater overall weighted PAF: 50.7% (45.3% to -56.1%), compared to men: 40.2% (35.4% to 45.0%), driven by a higher PAF for physical inactivity and depression in women. DISCUSSION: The PAF for modifiable risk factors for dementia in Chile is higher than in previous world reports, due to a greater prevalence of cardiovascular risk factors. Women have a higher potential for dementia prevention. HIGHLIGHTS: The proportion of dementia associated to modifiable risk factors in Chile is 45.8%.The main modifiable risk factors are high blood pressure, obesity, and hearing loss.Women had a greater prevalence of physical inactivity and depression than men.Chile had a greater prevalence of metabolic risk factors than other world regions.

Further characterization of relief dynamics in the conditioning and generalization of avoidance: Effects of distress tolerance and intolerance of uncertainty.

Avoidance behaviors are central to the anxiety disorders and implicated in many other forms of psychopathology, but the reinforcing mechanism of avoidance remains largely elusive. It has been suggested that subjective relief during successful omission of threat may serve as a reinforcer and contribute to the development of excessive avoidance. Also, relatively little is known about how avoidance behaviors generalize and what the role is of relief in generalization. The purpose of this experiment was three-fold: (1) to investigate the influence of anxiety-traits on the dynamics of relief during avoidance learning, (2) to characterize the dynamics of relief during avoidance generalization, and (3) to investigate the generalization of avoidance behavior over a dimension of avoidability. In a large sample of 101 participants, two lamp colors (CS+) were first associated with an aversive electrical stimulation (US), while a third color was not (CS-). Next, clicking a button during one CS + could effectively avoid the US (CS + av), but not during the other (CS + unav). Finally, avoidance generalization was tested via button clicks during morphed colors between CS + av and CS + unav (avoidability dimension), and to morphed colors between CS + av and CS- (safety dimension). Throughout the experiment, a relief rating scale appeared whenever a lamp color was not followed by the US. Results revealed that anxiety traits (distress tolerance and intolerance of uncertainty) were associated with higher levels of avoidance and subjective relief. In addition, gradients of avoidance generalization and relief were observed over dimensions of avoidability (CS + av → CS + unav) and safety (CS + av → CS-). Together, these results suggest a role for excessive relief in the development and generalization of maladaptive avoidance.

[Program of eating disorders in Chilean adolescents and young adults: six months outcome]. / Programa de transtornos de alimentación en adolescentes y jóvenes chilenos: variaciones a seis meses de tratamiento.

BACKGROUND: Eating disorders may have serious organic consequences derived from under nutrition, specific nutrient deficiencies and electrolytic disturbances and reach a mortality as high as 12%. AIM: To describe the features and outcome after six months of treatment of patients attending the Eating Disorders Unit at the Catholic University Hospital in Chile. MATERIAL AND METHODS: Review of medical records of patients with eating disorders that received a multidisciplinary treatment by a team of nutritionists, psychiatrists and psychologists and were seen at least twice in a period of six months. RESULTS: The records of 81 patients (mean age 16.3+/-3 years, only one male) were included in the review. Forty nine patients had Anorexia Nervosa of the restricting type, five of the purging type, 22 had Bulimia Nervosa of the purging type and two of the non purging type and three patients had an eating disorder not otherwise specified. Eighty percent consulted within the first year of symptom appearance. Sixty five percent came from families with both parents living together, 57% had a rigid and agglutinated family structure and 65% had occult crises. Depression or dysthymia was found in 45% of patients and drug therapy was required at the beginning of treatment in 25%. Obsessive traits (40.4%) were significantly related to restrictive eaters. A past history of obesity or overweight was common. After six months of treatment, body mass index increasing significantly in restrictive eaters with obsessive traits and occult family crises was noticed. CONCLUSIONS: A multidisciplinary therapeutic intervention improved body mass index and family symptoms in patients with restrictive eating disorders.