Depression stigma and treatment preferences among Orthodox and non-Orthodox Jews.

Anecdotal reports of increased stigma toward mental illness among Orthodox Jews seems to conflict with an existing literature describing less stigmatization toward depression among Jewish individuals. This online survey study investigated stigma toward depression and treatment preference among Orthodox and non-Orthodox Jews (N = 391). All participants were presented with a depression vignette to assess for stigma and then randomized to a vignette depicting a treatment modality (behaviorally oriented or insight oriented) to assess for treatment preference across several delivery options (individual, group, or Internet). Results indicated elevated depression stigma among Orthodox Jews as expressed by elevated levels of secrecy, treatment-seeking stigma, family/marriage stigma, and stigmatizing experiences, but not attitudinal social distancing. No group differences were found with respect to overall treatment preference, treatment modality, or manner of delivery. Overall, participants preferred individual therapy more than group and Internet therapy and preferred group therapy more than Internet therapy. Clinical and research implications are discussed.

20-Hydroxyeicosatetraenoic acid (20-HETE): Bioactions, receptors, vascular function, cardiometabolic disease and beyond.

Vascular function is dynamically regulated and dependent on a bevy of cell types and factors that work in concert across the vasculature. The vasoactive eicosanoid, 20-Hydroxyeicosatetraenoic acid (20-HETE) is a key player in this system influencing the sensitivity of the vasculature to constrictor stimuli, regulating endothelial function, and influencing the renin angiotensin system (RAS), as well as being a driver of vascular remodeling independent of blood pressure elevations. Several of these bioactions are accomplished through the ligand-receptor pairing between 20-HETE and its high-affinity receptor, GPR75. This 20-HETE axis is at the root of various vascular pathologies and processes including ischemia induced angiogenesis, arteriogenesis, septic shock, hypertension, atherosclerosis, myocardial infarction and cardiometabolic diseases including diabetes and insulin resistance. Pharmacologically, several preclinical tools have been developed to disrupt the 20-HETE axis including 20-HETE synthesis inhibitors (DDMS and HET0016), synthetic 20-HETE agonist analogues (20-5,14-HEDE and 20-5,14-HEDGE) and 20-HETE receptor blockers (AAA and 20-SOLA). Systemic or cell-specific therapeutic targeting of the 20-HETE-GPR75 axis continues to be an invaluable approach as studies examine the molecular underpinnings activated by 20-HETE under various physiological settings. In particular, the development and characterization of 20-HETE receptor blockers look to be a promising new class of compounds that can provide a considerable benefit to patients suffering from these cardiovascular pathologies.

Integration of the brief behavioral activation treatment for depression (BATD) into a college orientation program: depression and alcohol outcomes.

College freshmen face a variety of academic and social challenges as they adjust to college life that can place them at risk for a number of negative outcomes, including depression and alcohol-related problems. Orientation classes that focus on teaching incoming students how to better cope with college-oriented stress may provide an opportunity to prevent the development of these adjustment problems. This article outlines a program based on behavioral activation that can be integrated into college orientation programs to provide a more comprehensive orientation experience. Data are presented from an initial pilot study in which 71 first-semester freshman at the University of Maryland participated in a 15-week, 2 hr per week orientation class (n = 37 in the behavioral activation-enhanced orientation classes and n = 34 in the control orientation as usual classes). Students' depression and alcohol use were evaluated at the beginning, middle, and end of the course. Results indicated a Time × Group interaction such that problem drinking (but not consumption) was significantly reduced across assessments in the behavioral activation classes and largely unchanged in the standard classes. No difference was observed in depression scores; however, fairly low depression scores across the 3 time points may have limited the opportunity to observe any meaningful impact of the orientation classes on depression. The authors conclude with a discussion of the implications of their findings for preventing adjustment problems among incoming college students and future directions.

Factors associated with co-occurring borderline personality disorder among inner-city substance users: the roles of childhood maltreatment, negative affect intensity/reactivity, and emotion dysregulation.

The co-occurrence of borderline personality disorder (BPD) among individuals with substance use disorders is a common and clinically relevant phenomenon in need of further empirical investigation. The present study adds to the extant literature on the factors associated with co-occurring BPD among substance users, examining the relationships between childhood maltreatment (in the form of sexual, physical, and emotional abuse and emotional and physical neglect), negative affect intensity/reactivity, emotion dysregulation, and BPD pathology (both diagnostic status and symptom count) among a sample of 76 inner-city treatment-seeking substance users. Emotion dysregulation was expected to mediate the relationships between childhood maltreatment and negative affect intensity/reactivity (and their interaction) and BPD pathology. Results indicate that the presence of a BPD diagnosis was associated with higher levels of both childhood maltreatment and negative affect intensity/reactivity. However, only childhood maltreatment emerged as a unique predictor of BPD diagnostic status. Conversely, both childhood maltreatment and negative affect intensity/reactivity accounted for unique variance in the number of endorsed BPD symptoms. Moreover, emotion dysregulation fully mediated the relationships between maltreatment and negative affect intensity/reactivity and BPD symptom count, as well as the relationship between emotional abuse in particular and BPD diagnostic status. Contrary to hypotheses, results provided no support for the interaction between maltreatment and negative affect intensity/reactivity in the prediction of BPD pathology (diagnosis or symptom count), above and beyond the main effects of these factors.

Reactivity of tic observation procedures to situation and setting.

Tic frequency was assessed and compared across home and clinic as well as three experimentally-manipulated situations in order to assess the phenomenon of tic reactivity. Forty-three youngsters with chronic tic disorder recruited from two geographically-distinct sites were videotaped over three weekly laboratory visits under each of the following conditions: (1) alone/camera present, (2) other present/camera present, and (3) alone/camera hidden. Contrary to expectation, more tics were observed during overt as compared to covert observation, while the presence of another person had no overall impact on tic expression. Mean tic counts obtained from clinic observation did not significantly differ from those obtained at home collected either one day before or after. Tic frequency counts were remarkably stable over the three weekly assessments both at home and clinic. Study findings are consistent with past observations that tic expression can be influenced by environmental factors and suggest the stability of tic frequency may exhibit greater temporal and setting stability than previously thought. The clinical and research implications of these results are discussed.

The effect of contingent reinforcement on target variables in outpatient psychotherapy for depression: a successful and unsuccessful case using functional analytic psychotherapy.

The current study investigated a behavior-analytic treatment, functional analytic psychotherapy (FAP), for outpatient depression utilizing two single-subject A/A+B designs. The baseline condition was cognitive behavioral therapy. Results demonstrated treatment success in 1 client after the addition of FAP and treatment failure in the 2nd. This study highlights the challenges in measuring treatment progress and outcome idiographically in this population.

Acceptance and commitment therapy and behavioral activation for the treatment of depression: description and comparison.

The field of clinical behavior analysis is growing rapidly and has the potential to affect and transform mainstream cognitive behavior therapy. To have such an impact, the field must provide a formulation of and intervention strategies for clinical depression, the "common cold" of outpatient populations. Two treatments for depression have emerged: acceptance and commitment therapy (ACT) and behavioral activation (BA). At times ACT and BA may suggest largely redundant intervention strategies. However, at other times the two treatments differ dramatically and may present opposing conceptualizations. This paper will compare and contrast these two important treatment approaches. Then, the relevant data will be presented and discussed. We will end with some thoughts on how and when ACT or BA should be employed clinically in the treatment of depression.

Effects of exercise on Pavlovian fear conditioning.

Exercise promotes multiple changes in hippocampal morphology and should, as a result, alter behavioral function. The present experiment investigated the effect of exercise on learning using contextual and auditory Pavlovian fear conditioning. Rats remained inactive or voluntarily exercised (VX) for 30 days, after which they received auditory-cued fear conditioning. Twenty-four hours later, rats were tested for learning of the contextual and auditory conditional responses. No differences in freezing behavior to the discrete auditory cue were observed during the training or testing sessions. However, VX rats did freeze significantly more compared to controls when tested in the training context 24 hr after exposure to shock. The enhancement of contextual fear conditioning provides further evidence that exercise alters hippocampal function and learning.

What is behavioral activation? A review of the empirical literature.

Behavioral Activation (BA) for depression is an empirically supported psychotherapy with a long history dating back to the 1970s. To date there have been no systematic reviews of how BA treatment packages and their accompanying components have evolved over the years. This review sought to identify and describe the specific treatment components of BA based on the descriptions of techniques provided in empirical articles on BA and referenced treatment manuals when available. The following component techniques were identified: activity monitoring, assessment of life goals and values, activity scheduling, skills training, relaxation training, contingency management, procedures targeting verbal behavior, and procedures targeting avoidance. The implementation of these techniques is reviewed, along with their empirical support both as stand-alone components and as components of larger treatment packages. Whereas activity scheduling, relaxation, and skills training interventions have received empirical support on their own, other procedures have shown effectiveness as parts of larger treatment packages. Although BA interventions differed in tools used, activity monitoring and scheduling were shown to be constant components across interventions. Possible directions for the future evolution of BA are discussed.

A micro-process analysis of Functional Analytic Psychotherapy's mechanism of change.

This study sought to clarify the micro-process of Functional Analytic Psychotherapy (FAP) by using the Functional Analytic Psychotherapy Rating Scale (FAPRS) to code every client and therapist turn of speech over the course of successful treatment of an individual meeting diagnostic criteria for depression and histrionic personality disorder. Treatment consisted of cognitive behavioral therapy alone followed by the addition of FAP techniques in a unique A / A+B design. In-session client behavior improved following the shift to FAP techniques, and micro-process data suggested that client behavior was effectively shaped by in-vivo FAP procedures. These results support FAP's purported mechanisms of change and highlight the advantages of utilizing molecular coding systems to explore these mechanisms.

Long-term stability of fear memory depends on the synthesis of protein but not mRNA in the amygdala.

Synaptic modification supporting memory formation is thought to depend on gene expression and protein synthesis. Disrupting either process around the time of learning prevents the formation of long-term memory. Recent evidence suggests that memory also becomes susceptible to disruption upon retrieval. Whether or not the molecular events involved in the formation of new memory are the same as what is needed for memory to persist after retrieval has yet to be determined. In the present set of experiments, rats were given inhibitors of protein or messenger ribonucleic acid (mRNA) synthesis into the amygdala just after training or retrieval of fear memory. Results showed that blocking mRNA or protein synthesis immediately after learning prevented the formation of long-term memory, while stability of memory after retrieval required protein, but not mRNA, synthesis. These data suggest that the protein needed for memory reconsolidation after retrieval may be transcribed from pre-existing stores of mRNA.