A review of sleep disturbance in children and adolescents with anxiety.

The present review examines the relations between sleep disturbance and anxiety in children and adolescents. The review begins with a detailed discussion of normative developmental trends in sleep, and the relation between sleep quality and emotion dysregulation in children. The extant literature on sleep disturbance in clinically anxious children with a focus on subjective versus objective measures of sleep is then summarized in detail. Finally, a review of the reciprocal relationship between sleep and emotion regulation is provided. The available research suggests that sleep disturbance is quite prevalent in children with anxiety disorders, although the directionality of the association between sleep disturbance and anxiety in children remains unclear. Despite this limitation, a reciprocal relationship between sleep quality and anxiety appears to be well established. Research using objective measures of sleep quality (e.g. polysomnography, sleep actigraphy, sleep bruxism) is warranted to better understand this relation. Further, complicating factors such as the environment in which sleep quality is measured, the developmental stage of participants, varying severity of anxiety and the timeframe during which assessment takes place should all be considered when examining sleep disturbance in this population.

Rural and Urban/Suburban Families' Use of a Web-Based Mental Health Intervention.

Background/Introduction: Access to mental healthcare among rural residents is a national concern because unique barriers (e.g., fewer providers, distance to services) create significant challenges for the 60 million Americans who live in these settings. There is now a large body of literature demonstrating the efficacy of a wide range of Internet-based interventions. However, little is known about the extent to which individuals in rural settings will use these approaches and find them acceptable. Research with youths and their caregivers within this scope is particularly limited and, therefore, of great importance. METHODS: We examined access and completion of a Web-based disaster mental health intervention in a population-based sample of 1,997 rural (n = 676) and urban/suburban (n = 1,321) adolescents and their caregivers who were affected by the Spring 2011 tornadoes that touched down in parts of Missouri and Alabama. RESULTS: Results indicated no differences in the rate of access or completion of Web-based modules based on geographical location. Furthermore, for those who did not access the Web-based resource, no differences were observed with respect to reasons for not accessing modules based on geographical location. DISCUSSION: These data have promising implications for the reach of Web-based resources to both rural and urban/suburban communities, as well as the willingness of adolescents and their caregivers to access and complete such resources, regardless of geographical location.

Aqueous Emulsion Droplets Stabilized by Lipid Vesicles as Microcompartments for Biomimetic Mineralization.

Mineral deposition within living cells relies on control over the distribution and availability of precursors as well as the location and rates of nucleation and growth. This control is provided in large part by biomolecular chelators, which bind precursors and regulate their availability, and compartmentalization within specialized mineralizing vesicles. Biomimetic mineralization in self-assembled lipid vesicles is an attractive means of studying the mineralization process, but has proven challenging due to vesicle heterogeneity in lamellarity, contents, and size across a population, difficulties encapsulating high and uniform precursor concentrations, and the need to transport reagents across an intact lipid bilayer membrane. Here, we report the use of liposome-stabilized all-aqueous emulsion droplets as simple artificial mineralizing vesicles (AMVs). These biomimetic microreactors allow the entry of precursors while retaining a protein catalyst by equilibrium partitioning between internal and external polymer-rich phases. Small molecule chelators with intermediate binding affinity were employed to control Ca(2+) availability during CaCO3 mineralization, providing protection against liposome aggregation while allowing CaCO3 formation. Mineral deposition was limited to the AMV interior, due to localized production of CO3(2-) by compartmentalized urease. Particle formation was uniform across the entire population of AMVs, with multiple submicrometer amorphous CaCO3 particles produced in each one. The all-aqueous emulsion-based approach to biomimetic giant mineral deposition vesicles introduced here should be adaptable for enzyme-catalyzed synthesis of a wide variety of materials, by varying the metal ion, enzyme, and/or chelator.

Do peritraumatic emotions differentially predict PTSD symptom clusters? Initial evidence for emotion specificity.

This study investigated whether specific peritraumatic emotions differentially predict PTSD symptom clusters in individuals who have experienced stressful life events. Hypotheses were developed based on the SPAARS model of PTSD. It was predicted that the peritraumatic emotions of anger, disgust, guilt, and fear would significantly predict re-experiencing and avoidance symptoms, while only fear would predict hyperarousal. Undergraduate students (N = 144) participated in this study by completing a packet of self-report questionnaires. Multiple regression analyses were conducted with PCL-S symptom cluster scores as dependent variables and peritraumatic fear, guilt, anger, shame, and disgust as predictor variables. As hypothesized, peritraumatic anger, guilt, and fear all significantly predicted re-experiencing. However, only fear predicted avoidance, and anger significantly predicted hyperarousal. Results are discussed in relation to the theoretical role of emotions in the etiology of PTSD following the experience of a stressful life event.

How Stable, Really? Traditional and Nonlinear Dynamics Approaches to Studying Temporal Fluctuations in Personality and Affect.

A pair of quantitative case studies is presented to demonstrate how different approaches to quantifying temporal variability in ratings of traits and affect can provide rich information for personality researchers. Data are presented and analyzed from two college students who completed an Ecological Momentary Assessment protocol sampling ratings of affect and traits up to 24 times daily for one week. Both classical and nonlinear data analytic techniques were applied to the data to summarize and examine the temporal dynamics of both traits and affect. For the purposes of exposition, one Big Five trait rating, extraversion, and the PANAS positive and negative affects, are discussed. The results support previous research demonstrating a high degree of variability in ratings of both traits and affect over time. Analyses using nonlinear and complexity expand on these findings and suggest temporal patterning as well as disorder; implications of phase portraits for understanding variability are discussed. The findings are discussed in light of a processing dynamics approach to resolving the role of variability in understanding personality.

A Critical Review of Negative Affect and the Application of CBT for PTSD.

Forms of cognitive and behavioral therapies (CBTs), including prolonged exposure and cognitive processing therapy, have been empirically validated as efficacious treatments for posttraumatic stress disorder (PTSD). However, the assumption that PTSD develops from dysregulated fear circuitry possesses limitations that detract from the potential efficacy of CBT approaches. An analysis of these limitations may provide insight into improvements to the CBT approach to PTSD, beginning with an examination of negative affect as an essential component to the conceptualization of PTSD and a barrier to the implementation of CBT for PTSD. As such, the literature regarding the impact of negative affect on aspects of cognition (i.e., attention, processing, memory, and emotion regulation) necessary for the successful application of CBT was systematically reviewed. Several literature databases were explored (e.g., PsychINFO and PubMed), resulting in 25 articles that met criteria for inclusion. Results of the review indicated that high negative affect generally disrupts cognitive processes, resulting in a narrowed focus on stimuli of a negative valence, increased rumination of negative autobiographical memories, inflexible preservation of initial information, difficulty considering counterfactuals, reliance on emotional reasoning, and misinterpretation of neutral or ambiguous events as negative, among others. With the aim to improve treatment efficacy of CBT for PTSD, suggestions to incorporate negative affect into research and clinical contexts are discussed.

Affect and neural activity in women with PTSD during a task of emotional interference.

BACKGROUND: The current study sought to determine the relationship between self-reported dimensions of affect and activation in brain regions associated with emotion regulation in PTSD during a task of non-conscious emotional processing in interpersonal trauma survivors with PTSD and healthy controls. METHODS: Participants included 52 women diagnosed with PTSD and 18 female healthy controls. All participants completed a clinical assessment including the SCID, CAPS, and PANAS followed by a functional MRI assessment including a task of implicit emotional conflict. RESULTS: When PTSD participants were oriented to fearful faces, negative affect (NA) was inversely related to activation in the left amygdala and positive affect (PA) was inversely related to activation in the right amygdala. When ignoring fearful faces, NA was positively associated with activation in the right parahippocampal gyrus and PA was inversely related to activation in the left hippocampus. Similar results were observed in healthy controls regarding PA. However, NA was not significantly related to any region of interest in healthy controls. LIMITATIONS: Limitations include the homogeneity of the healthy controls with regard to racial diversity, results may only be specific to female interpersonal trauma survivors with PTSD, and neutral faces within the conflict task may be perceived as negative by clinical samples. CONCLUSIONS: Persistent, increased NA may represent a proxy for disruptions in emotional processing in interpersonal trauma survivors with PTSD. As such, clinicians may prioritize increasing emotional awareness through emotion regulation and/or distress tolerance strategies in this population.

The impact of ecological momentary assessment on posttraumatic stress symptom trajectory.

Ecological momentary assessment includes continuous, real-time gathering of self-report data in a participant's natural environment. The current study evaluated the possible impact of this assessment strategy on severity of posttraumatic stress (PTS) in a sample of participants who reported experiencing a past traumatic event. Participants with clinically elevated PTS symptoms reported symptom severity at three time-points: during an initial screening, following an unmonitored period, and following two weeks of monitoring. During the monitoring period, participants carried an Android device which prompted them to report PTS symptoms and negative emotions six times daily. PTS severity scores were then compared across these three time-points. Results indicated that participating in the ecological momentary assessment protocol was associated with a significant reduction in PTS severity, whereas significant changes were not noted over the unmonitored control condition. The authors conclude that ecological momentary assessment may have therapeutic value even when not combined with formal intervention, and it may be a useful tool for improving the efficiency of a stepped-care approach to treating PTS symptoms.

Development of a new measure for assessing insight: Psychometric properties of the insight orientation scale (IOS).

INTRODUCTION: Given the centrality of insight in promoting change, the relevance of measures for assessing this construct has become increasingly clear. This paper describes a new self-report measure for assessing some of the characteristics of insight, the insight orientation scale (IOS). AIMS: In study 1, we evaluated the factor structure and the reliability of the scale. In study 2, we analyzed the concurrent and discriminant validity of the scale in patients with different clinical diagnoses. METHODS: In study 1 participants were 600 individuals (41.1% male, 58.9% female) with a mean age of 33.95 years (SD = 13.04). In study 2 participants were 136 individuals divided into the following groups: 1) schizophrenia spectrum and other psychotic disorders (n = 26); 2) substance-related disorders (n = 55); 3) depressive disorders (n = 27); and 4) personality disorders (n = 28). INSTRUMENTS: Instruments are the insight orientation scale (IOS) and the Beck cognitive insight scale. RESULTS: The goodness-of-fit indices showed a satisfactory fit of a one factor model. We found also a good internal consistency (α = .77). CONCLUSIONS: These findings support the dimensionality of the IOS and suggest that it may be useful as an assessment tool for use in guiding psychotherapy.

Bioreactor droplets from liposome-stabilized all-aqueous emulsions.

Artificial bioreactors are desirable for in vitro biochemical studies and as protocells. A key challenge is maintaining a favourable internal environment while allowing substrate entry and product departure. We show that semipermeable, size-controlled bioreactors with aqueous, macromolecularly crowded interiors can be assembled by liposome stabilization of an all-aqueous emulsion. Dextran-rich aqueous droplets are dispersed in a continuous polyethylene glycol (PEG)-rich aqueous phase, with coalescence inhibited by adsorbed ~130-nm diameter liposomes. Fluorescence recovery after photobleaching and dynamic light scattering data indicate that the liposomes, which are PEGylated and negatively charged, remain intact at the interface for extended time. Inter-droplet repulsion provides electrostatic stabilization of the emulsion, with droplet coalescence prevented even for submonolayer interfacial coatings. RNA and DNA can enter and exit aqueous droplets by diffusion, with final concentrations dictated by partitioning. The capacity to serve as microscale bioreactors is established by demonstrating a ribozyme cleavage reaction within the liposome-coated droplets.

Promotora de salud: promoting folic acid use among Hispanic women.

BACKGROUND: The U.S. Public Health Service recommends that all women in the United States capable of becoming pregnant consume 400 µg of folic acid daily to reduce their risk of having a pregnancy affected by a neural tube defect (NTD). However, disparities exist in the consumption of folic acid, with Hispanic women having lower rates of folic acid consumption than non-Hispanic white women. METHODS: A community-based feasibility study was designed to assess the utility of the promotora de salud model to promote consumption of multivitamins containing folic acid for the prevention of NTDs among Spanish-speaking Hispanic women in North Carolina. The study consisted of an educational intervention given by a promotora (a lay, community health worker), with data collection occurring at baseline and four months post-intervention to measure changes in knowledge and behavior. Overall, 52% (n=303) of participants completed all components of the study. RESULTS: Self-reported daily multivitamin consumption increased from 24% at baseline to 71% four months post-intervention. During the same time frame, awareness of folic acid increased from 78% to 98% and knowledge of the role of folic acid in the prevention of birth defects increased from 82% to 92%. CONCLUSIONS: The results of this study indicate that the promotora de salud model may be effective in reaching a subpopulation of women with the folic acid message. Additional studies with larger population sizes are warranted to validate these findings.