Functional connectivity between the nucleus accumbens and amygdala underlies avoidance learning during adolescence: Implications for developmental psychopathology.

BACKGROUND: Reward and threat processes work together to support adaptive learning during development. Adolescence is associated with increasing approach behavior (e.g., novelty-seeking, risk-taking) but often also coincides with emerging internalizing symptoms, which are characterized by heightened avoidance behavior. Peaking engagement of the nucleus accumbens (NAcc) during adolescence, often studied in reward paradigms, may also relate to threat mechanisms of adolescent psychopathology. METHODS: 47 typically developing adolescents (9.9-22.9 years) completed an aversive learning task during functional magnetic resonance imaging, wherein visual cues were paired with an aversive sound or no sound. Task blocks involved an escapable aversively reinforced stimulus (CS+r), the same stimulus without reinforcement (CS+nr), or a stimulus that was never reinforced (CS-). Parent-reported internalizing symptoms were measured using Revised Child Anxiety and Depression Scales. RESULTS: Functional connectivity between the NAcc and amygdala differentiated the stimuli, such that connectivity increased for the CS+r (p = .023) but not for the CS+nr and CS-. Adolescents with greater internalizing symptoms demonstrated greater positive functional connectivity for the CS- (p = .041). CONCLUSIONS: Adolescents show heightened NAcc-amygdala functional connectivity during escape from threat. Higher anxiety and depression symptoms are associated with elevated NAcc-amygdala connectivity during safety, which may reflect poor safety versus threat discrimination.

You changed my mind: Immediate and enduring impacts of social emotion regulation.

As social creatures, our relationships with other people have tremendous downstream impacts on health and well-being. However, we still know surprisingly little about how our social interactions regulate how we think and feel through life's challenges. Getting help from other people to change how one thinks about emotional events-known as "social reappraisal"-can be more effective in downregulating negative affect than reappraising on one's own, but it is unknown whether this regulatory boost from social support persists when people face the same events alone in the future. In a preregistered study of 120 young adults (N = 60 same-gender dyads, gender-split sample) involving in-lab emotion regulation tasks and a follow-up task online approximately 1 day later, we found that participants responded less negatively to aversive images that were socially regulated (i.e., reappraised with the help of a friend) both immediately and over time, as compared to images that had been solo regulated (i.e., reappraised on one's own) or not regulated (i.e., passively viewed). Interestingly, the regulatory boost from social support observed both in the lab and at follow-up was driven by women dyads. This work highlights one important mechanism explaining how support from others can facilitate emotional well-being: By changing peoples' lasting impressions of distressing events, interactions with others can help prepare them to cope with future exposure to those events on their own, underscoring how valuable others' perspectives can be when navigating ongoing emotional stressors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Development of outcome measures for autoimmune dermatoses.

Validated outcome measures are essential in monitoring disease severity. Specifically in dermatology, which relies heavily on the clinical evaluation of the patient and not on laboratory values and radiographic tests, outcome measures help standardize patient care. Validated cutaneous scoring systems, much like standardized laboratory values, facilitate disease management and follow therapeutic response. Several cutaneous autoimmune dermatoses, specifically cutaneous lupus erythematosus (CLE), dermatomyositis (DM), and pemphigus vulgaris (PV), lack such outcome measures. As a result, evaluation of disease severity and patients' response to therapy over time is less reliable. Ultimately, patient care is compromised. These diseases, which are often chronic and relapsing and remitting, are also often refractory to treatment. Without outcome measures, new therapies cannot be systematically assessed in these diseases. Clinical trials that are completed without standardized outcome measures produce less reliable results. Therefore, the development of validated outcome measures in these autoimmune dermatoses is critical. However, the process of developing these tools is as important, if not more so, than their availability. This review examines the steps that should be considered when developing outcome measures, while further examining their importance in clinical practice and trials. Finally, this review more closely looks at CLE, DM, and PV and addresses the recent and ongoing progress that has been made in the development of their outcome measures.

Cross-sectional analysis of a collaborative Web-based database for lupus erythematosus-associated skin lesions: prospective enrollment of 114 patients.

OBJECTIVES: To assess disease severity in subsets of patients with cutaneous lupus erythematosus (CLE) by using outcome and quality-of-life measures, and to determine treatment responsiveness by establishing a Web-based database of patients with skin manifestations of lupus. DESIGN: Prospective, cross-sectional study. SETTING: University hospital cutaneous autoimmunity outpatient clinic. PATIENTS: One hundred fourteen patients who presented from January 15, 2007, to November 8, 2007, and met the criteria for having CLE or lupus-nonspecific skin disease. MAIN OUTCOME MEASURES: Scores on the CLE Disease Activity and Severity Index and the modified Skindex-29 (a quality-of-life measure) completed at each visit. RESULTS: Seven patients (6.1%) presented with acute CLE, 21 (18.4%) with subacute CLE, 77 (67.5%) with chronic CLE, 7 (6.1%) with systemic lupus erythematosus and LE-nonspecific skin lesions, and 1 (0.9%) with LE-nonspecific skin disease only. The mean baseline CLE Disease Activity and Severity Index activity/damage scores in patients with acute, subacute, and chronic CLE were 6.4/5.1, 11.1/1.6, and 7.5/10.2, respectively. The mean baseline modified Skindex-29 scores were 76.3, 79.4, and 82.7, respectively (P = .80). The disease in 11 of the patients (9.6%) was considered refractory to conventional therapies. Significantly more patients in the refractory group than the nonrefractory group were current smokers (P = .006). CONCLUSION: This Web-based database should allow collection of data related to disease activity, quality of life, and response to therapy at multiple centers.

Supporting older youth: what's policy got to do with it?

The nonschool hours are an underused tool in supporting older youth in their transition to adulthood. Given competing demands on many teens' time and a host of other developmental realities, effective strategies for engaging high schoolers look much different from those of their younger counterparts, and those differences have programmatic and policy implications. Effective youth policies reflect an overarching vision that is about changing lives--a vision that addresses a range of risk and protective factors, simultaneously supports discrete programs and builds coherent pathways to success, and recognizes that children and youth grow up in families and communities. This chapter highlights policy innovations related to teens' involvement in out-of-school-time activities and then looks at three principles that can help ensure that youth policy supports the full range of older youth's unique developmental, social, and economic needs.