Does Childhood Trauma Predict Impulsive Spending in Later Life? An Analysis of the Mediating Roles of Impulsivity and Emotion Regulation.

We sought to investigate whether adverse childhood experiences increase impulsive spending in later life, and whether emotion dysregulation and impulsivity mediate this association. Limited research has examined associations between these factors, and examining the mechanisms involved may inform interventions for impulsive spending. This study used a cross-sectional, correlational design including 189 adult participants who completed an online survey assessing childhood trauma, adverse childhood experiences, impulsive spending, impulsivity, and emotion dysregulation. Greater adverse childhood experiences and childhood trauma were positively correlated with impulsive spending, as well as general impulsivity and emotion dysregulation. Mediation analyses indicated that emotion dysregulation and greater impulsivity accounted for the positive relationship between childhood trauma and impulse spending. Adverse childhood experiences and childhood trauma are associated with increased risk of impulse spending in adulthood via elevated general impulsivity and emotion dysregulation.

Are dysfunctional attitudes elevated and linked to mood in bipolar disorder? A systematic review and meta-analysis.

OBJECTIVES: Dysfunctional attitudes (DA) are higher in depression; however, less is understood about their role in bipolar disorder (BD). This paper aimed to explore the presence of DA in BD in comparison to clinical and non-clinical groups. Also explored were the associations between DA and mood states of depression, mania or euthymia in BD. METHODS: A systematic review and meta-analysis were conducted. A total of 47 articles were included in the systematic review of which 23 were included in the meta-analysis. The quality of each study was rated. RESULTS: The meta-analysis showed significantly higher DA in BD than healthy controls (d = .70). However, no difference was observed between BD and unipolar participants (d = -.16). When reviewing mood state within BD, a significant mean difference was found between DA scores for euthymic and depressed participants (d = -.71), with those who were depressed scoring higher. Three studies found that psychological therapies significantly reduce DA in BD (d = -.38). CONCLUSIONS: These findings imply not only that DA are both a characteristic of BD that is not as prevalent in healthy populations but also that a depressed mood state is associated with increased severity. This implies that DA could possibly go 'offline' when mood symptoms are not present. Psychological therapies appear to reduce DA in BD. Implications for future research as well as practice-based implications are expanded on in the discussion.

The relationship between dysfunctional attitudes, maladaptive perfectionism, metacognition and symptoms of mania and depression in bipolar disorder: The role of self-compassion as a mediating factor.

BACKGROUND: Maladaptive cognitions appear to be associated with the severity of mood symptoms in bipolar disorder (BD), but findings are mixed and generally cross-sectional in design. METHOD: This study (n = 331) explored the associations between maladaptive cognitions and mood symptoms in BD over time (3 months), and the potential mediating effect of self-compassion cross-sectionally. Dysfunctional attitudes, maladaptive perfectionism and maladaptive metacognitions were explored separately with depressive and manic symptoms, and with current mood state in BD. RESULTS: The results showed maladaptive metacognitions to be the only significant predictor of depression at 3-month follow-up (ß = 0.31, p < .001), with no relationship to mania over time. Cross-sectionally, self-compassion partially mediated the relationship between all maladaptive cognitions and depression, with higher dysfunctional cognitions and lower self-compassion predicting increased severity of depressive symptoms. Only the relationship between dysfunctional attitudes and mania was partially mediated by self-compassion, however, the relationship was weak and suggestive that higher self-compassion predicted increased mania. LIMITATIONS: The study duration limited the possible analysis. Future longitudinal research is needed. Also, the study sample was not representative of the clinical population, making results less generalisable. Additionally, limited significant findings regarding manic symptoms supports the need for further research into active cognitions during this phase of BD. CONCLUSIONS: Maladaptive metacognitions were predictive of future depression severity, therefore, further exploration of metacognitive therapy for BD should be explored. Furthermore, self-compassion was shown to partially mediate the relationship between negative cognitions and mood, therefore further exploration of compassion-based therapies for BD is needed.

Social network position is a major predictor of ant behavior, microbiota composition, and brain gene expression.

The physiology and behavior of social organisms correlate with their social environments. However, because social environments are typically confounded by age and physical environments (i.e., spatial location and associated abiotic factors), these correlations are usually difficult to interpret. For example, associations between an individual's social environment and its gene expression patterns may result from both factors being driven by age or behavior. Simultaneous measurement of pertinent variables and quantification of the correlations between these variables can indicate whether relationships are direct (and possibly causal) or indirect. Here, we combine demographic and automated behavioral tracking with a multiomic approach to dissect the correlation structure among the social and physical environment, age, behavior, brain gene expression, and microbiota composition in the carpenter ant Camponotus fellah. Variations in physiology and behavior were most strongly correlated with the social environment. Moreover, seemingly strong correlations between brain gene expression and microbiota composition, physical environment, age, and behavior became weak when controlling for the social environment. Consistent with this, a machine learning analysis revealed that from brain gene expression data, an individual's social environment can be more accurately predicted than any other behavioral metric. These results indicate that social environment is a key regulator of behavior and physiology.

Self-compassion as a mediator of the relationship between childhood sexual abuse and psychotic symptoms in clinical and non-clinical groups.

BACKGROUND: Previous research has shown a link between childhood sexual abuse (CSA) and more severe symptoms of psychosis. There is also evidence that self-compassion is a key mechanism linking adverse childhood experiences and mental health problems such as post-traumatic stress disorder and depression, but no research has examined these links in psychosis. METHODS: We analysed existing cross-sectional data, including 55 individuals with psychosis and 166 individuals from the general population. Participants completed standardized measures of CSA, self-compassion, paranoia, positive psychotic symptoms and distress linked to psychosis. RESULTS: The clinical group had higher scores on CSA and all psychosis measures, but we found no differences in self-compassion between the groups. Higher levels of CSA correlated with lower self-compassion and higher paranoia and positive symptoms in both groups. CSA also correlated with distress linked to psychosis in the non-clinical group. Lower self-compassion mediated the association between higher levels of CSA and more severe paranoia in both groups. In the non-clinical group, lower self-compassion also mediated the association between greater CSA and more positive psychotic symptoms and more severe distress. CONCLUSIONS: This is the first study to show that self-compassion mediates the link between CSA and both paranoia and psychotic symptoms in adulthood. Self-compassion may therefore be an important transdiagnostic candidate target in therapy to mitigate the impact of early adversity on paranoia in both clinical and non-clinical groups. Limitations include the small clinical sample and inclusion of a cannabis-using non-clinical sample, though recent cannabis use did not impact self-compassion levels.

Individual emergency response and recovery: What people worried about during and after Hurricane Maria.

Hurricane Maria was a disastrous weather event that devastated Puerto Rico (PR) in September 2017. Yet, little is known about people's perceptions of this event. In this investigation, we offer insight about Hurricane Maria's impact on PR's inhabitants. More specifically, we study a sample (n = 542 responses) of individuals' worry levels through four time points during the aftermath of Hurricane Maria: their variation through time, their relationship to decision making, and if and how certain demographic variables may influence them. For these purposes, we designed and implemented the Individual Emergency Response and Recovery Questionnaire, a web-based survey that measured several aspects of the objective and subjective experiences of individuals who underwent Hurricane Maria in PR. Results of a statistical analysis using nonparametric tests show that some of the demographic variables selected as factors of interest influence the worry levels reported by respondents. Most significant results coincide with conclusions drawn by literature: that time, age group, and the level of information influence worry levels. Another key finding is that the worry level may influence individual decision-making frequency. Understanding principal factors in people's behavior and perceptions during hurricanes is crucial to help us learn how to better prepare for and respond to natural disasters in the future.

Functional and mechanistic diversity in ant tandem communication.

Communication is fundamental to the organization of animal societies, often resulting in the convergent evolution of similar social behavior across lineages. However, this similarity may conceal underlying functional and mechanistic differences. Here we combined network and information-theoretic analysis to quantify how tandem recruitment is distinguishable between two ant genera, Temnothorax and Diacamma. We show that Temnothorax uses tandem running to recruit additional recruiters, while Diacamma uses it principally to move the passive majority of their colony, a task that Temnothorax accomplishes with a different behavior, social carrying. Accordingly, the network structure of Diacamma tandems was dissimilar to that of Temnothorax, instead resembling the social-carrying networks in Temnothorax. Furthermore, our information-theoretical analysis on movement trajectories revealed that Diacamma tandem runs lack bidirectional information transfer, the signature of route learning in Temnothorax. By quantifying the diversity of similar communication systems, this study increases the resolution of our understanding of animal societies.

Reducing incidence of postoperative acute kidney injury in trauma and orthopaedics patients: a quality improvement project.

BACKGROUND: Acute kidney injury (AKI) is a common postoperative complication which increases morbidity and mortality. This quality improvement project aimed to implement measures targeting known risk factors to decrease the incidence of postoperative AKI in trauma and orthopaedics (T&O) patients. METHODS: Data were collected across three six-month to 7-month cycles between 2017 and 2020, analysing all elective and emergency T&O operated patients within a single NHS Trust (n=714, 1008 and 928, respectively). Patients who developed a postoperative AKI were identified using biochemical criteria and data were collected on known AKI risk factors, including use of nephrotoxic medications, and patient outcomes. In the final cycle, the same variables were collected for patients without AKI. Between cycles, measures implemented included: preoperative and postoperative medication reconciliation aiming to stop nephrotoxic medications, orthogeriatrician review of high-risk patients and junior doctor teaching on fluid therapy. Statistical analysis was undertaken to determine the incidence of postoperative AKI across cycles, prevalence of risk factors and impact on length of hospital stay and postoperative mortality. RESULTS: There was a statistically significant decrease in postoperative AKI incidence from 4.27% (43 of 1008 patients) in cycle 2 to 2.05% (19 of 928) in cycle 3 (p=0.006), with a notable decrease in use of nephrotoxic medications. Significant predictors for the development of postoperative AKI included use of diuretics and receiving multiple nephrotoxic drug classes. Development of postoperative AKI significantly increased length of hospital stay by 7.11 days on average (95% CI: 4.84 to 9.38 days, p<0.001) and risk of 1-year postoperative mortality (OR 3.22, 95% CI: 1.03 to 10.55, p=0.046). CONCLUSION: This project demonstrates that a multifaceted approach targeting modifiable risk factors can reduce incidence of postoperative AKI in T&O patients, which may lead to reduced length of hospital stay and postoperative mortality.

The Relationship between Mood Symptom Severity and Perfectionism Subtypes in Mood Disorders: A Systematic Review and Meta-Analysis.

BACKGROUND: Previous research suggests that there is a link between perfectionism and symptoms of depression. This study aimed to see if different types of perfectionism are linked differently to symptoms of depression in mood disorders and if there is a relationship between perfectionism and symptoms of mania in bipolar disorder. METHODS: A systematic search was conducted in the databases PsycINFO, EMBASE, Web of Science, and PubMed to find papers which examined the relationship in clinical depression and bipolar disorder. A meta-analysis pooled the correlation effect sizes for mood symptoms severity and the severity of the perfectionism subtype. RESULTS: Twelve papers were included in the review, with five of these being included in the meta-analysis. The meta-analysis found statistically significant positive correlations between greater severity of depression symptoms and more severe perfectionism for the following subtypes: concern over mistakes, doubts about actions, other-oriented perfectionism, parental criticism, self-oriented perfectionism, and socially prescribed perfectionism. There was no significant relationship between depression symptoms and perfectionism subtypes of organisation and personal standards. There were not enough studies reporting data for manic symptoms for the meta-analysis or for any firm conclusions to be drawn. CONCLUSIONS: The relationship between depression and perfectionism differs depending on the particular type of perfectionism examined. Most studies were cross-sectional and correlational, so causation cannot be inferred, and future longitudinal studies are needed.

High-altitude vertical wind profile estimation using multirotor vehicles.

Capturing vertical profiles of the atmosphere and measuring wind conditions can be of significant value for weather forecasting and pollution monitoring however, collecting such data can be limited by current approaches using balloon-based radiosondes and expensive ground-based sensors. Multirotor vehicles can be significantly affected by the local wind conditions, and due to their under-actuated nature, the response to the flow is visible in the changes in the orientation. From these changes in orientation, wind speed and direction estimates can be determined, allowing accurate estimation with no additional sensors. In this work, we expand on and improve this method of wind speed and direction estimation and incorporate corrections for climbing flight to improve estimation during vertical profiling. These corrections were validated against sonic anemometer data before being used to gather vertical profiles of the wind conditions around Volcan De Fuego in Guatemala up to altitudes of 3000 m Above Ground Level (AGL). From the results of this work, we show we can improve the accuracy of multirotor wind estimation in vertical profiling through our improved model and some of the practical limitations of radiosondes that can be overcome through the use of UAS in this application.

Repopulation of decellularized organ scaffolds with human pluripotent stem cell-derived pancreatic progenitor cells.

Diabetes is an emerging global epidemic that affects more that 285 million people worldwide. Engineering of endocrine pancreas tissue holds great promise for the future of diabetes therapy. Here we demonstrate the feasibility of re-engineering decellularized organ scaffolds using regenerative cell source. We differentiated human pluripotent stem cells (hPSC) toward pancreatic progenitor (PP) lineage and repopulated decellularized organ scaffolds with these hPSC-PP cells. We observed that hPSCs cultured and differentiated as aggregates are more suitable for organ repopulation than isolated single cell suspension. However, recellularization with hPSC-PP aggregates require a more extensive vascular support, which was found to be superior in decellularized liver over the decellularized pancreas scaffolds. Upon continued culture for nine days with chemical induction in the bioreactor, the seeded hPSC-PP aggregates demonstrated extensive and uniform cellular repopulation and viability throughout the thickness of the liver scaffolds. Furthermore, the decellularized liver scaffolds was supportive of the endocrine cell fate of the engrafted cells. Our novel strategy to engineer endocrine pancreas construct is expected to find potential applications in preclinical testing, drug discovery and diabetes therapy.

Orbital cellulitis and cavernous sinus thrombosis with contralateral sinus disease in a COVID-19 positive adolescent patient.

Patients with COVID-19 have been reported to have elevated coagulation factors, which is a well-documented cause of venous thromboembolism events such as deep vein thrombosis and pulmonary embolism. Other venous thrombotic events, however, such as cavernous sinus thrombosis (CST) have been less commonly observed, specifically in combination with primary orbital cellulitis. Due to its unique anatomic location, the cavernous sinus is susceptible to thrombophlebitis processes including septic thrombosis and thrombosis most commonly from sinusitis. Many studies have shown that in the antibiotic era thromboembolic events of the cavernous sinus are less common due to infection spread from the orbit or facial region. This case report describes a 17-year-old COVID-19 positive male who presented with a left-sided primary orbital cellulitis with CST without radiographic evidence of ipsilateral sinus disease.

Coherent modeling of longitudinal causal effects on binary outcomes.

Analyses of biomedical studies often necessitate modeling longitudinal causal effects. The current focus on personalized medicine and effect heterogeneity makes this task even more challenging. Toward this end, structural nested mean models (SNMMs) are fundamental tools for studying heterogeneous treatment effects in longitudinal studies. However, when outcomes are binary, current methods for estimating multiplicative and additive SNMM parameters suffer from variation dependence between the causal parameters and the noncausal nuisance parameters. This leads to a series of difficulties in interpretation, estimation, and computation. These difficulties have hindered the uptake of SNMMs in biomedical practice, where binary outcomes are very common. We solve the variation dependence problem for the binary multiplicative SNMM via a reparameterization of the noncausal nuisance parameters. Our novel nuisance parameters are variation independent of the causal parameters, and hence allow for coherent modeling of heterogeneous effects from longitudinal studies with binary outcomes. Our parameterization also provides a key building block for flexible doubly robust estimation of the causal parameters. Along the way, we prove that an additive SNMM with binary outcomes does not admit a variation independent parameterization, thereby justifying the restriction to multiplicative SNMMs.

A validation of the PCL-5 questionnaire for PTSD in primary and secondary care.

OBJECTIVE: This paper explored the factor structure of the PCL-5 within a sample of U.K. primary and secondary care mental health service users. Much of the previous investigations into the PCL-5 have been conducted on military or emergency service personnel; therefore, it is important to understand the validity of this tool within a broader sample. In addition to this concerns have been raised over the statistical validity of much of the previous research. METHOD: An exploratory factor analysis was used to determine the factor structure of the PCL-5 within this population. RESULTS: The results of this study suggest that several items of the PCL-5 should be removed, and this presents a 3-factor structure whereby the factors are Anhedonia, Intrusion and Negative alterations in Mood and Cognition. CONCLUSIONS: This challenges much of the previous literature, which suggested 4, 6, and 7 factor models. The implications of this are discussed in detail in this paper. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Is there a 'bipolar iceberg' in UK primary care psychological therapy services?

BACKGROUND: Improving Access to Psychological Therapies (IAPT) is a primary care therapy service commissioned by England's National Health Service (NHS) for people with unipolar depression and anxiety-related disorders. Its scope does not extend to 'severe mental illness', including bipolar disorders (BD), but evidence suggests there is a high BD prevalence in ostensibly unipolar major depressive disorder (uMDD) samples. This study aimed to indicate the prevalence and characteristics of people with BD in a naturalistic cohort of IAPT patients. METHODS: 371 participants were assessed before initiating therapy. Participants were categorised by indicated diagnoses: BD type-I (BD-I) or type-II (BD-II) as defined using a DSM diagnostic interview, bipolar spectrum (BSp, not meeting diagnostic criteria but exceeding BD screening thresholds), lifetime uMDD or other. Information about psychiatric history and co-morbidities was examined, along with symptoms before and after therapy. RESULTS: 368 patients provided sufficient data to enable classification. 10% of participants were grouped as having BD-I, 20% BD-II, 40% BSp, 25% uMDD and 5% other. BD and uMDD participants had similar demographic characteristics, but patients meeting criteria for BD-I/BD-II had more complex psychiatric presentations. All three 'bipolar' groups had particularly high rates of anxiety disorders. IAPT therapy receipt was comparable between groups, as was therapy response (F9704 = 1.113, p = 0.351). CONCLUSIONS: Notwithstanding the possibility that bipolar diathesis was overestimated, findings illustrate a high prevalence of BD in groups of people notionally with uMDD or anxiety. As well as improving the detection of BD, further substantive investigation is required to establish whether individuals affected by BD should be eligible for primary care psychological intervention.

Two simple movement mechanisms for spatial division of labour in social insects.

Many animal species divide space into a patchwork of home ranges, yet there is little consensus on the mechanisms individuals use to maintain fidelity to particular locations. Theory suggests that animal movement could be based upon simple behavioural rules that use local information such as olfactory deposits, or global strategies, such as long-range biases toward landmarks. However, empirical studies have rarely attempted to distinguish between these mechanisms. Here, we perform individual tracking experiments on four species of social insects, and find that colonies consist of different groups of workers that inhabit separate but partially-overlapping spatial zones. Our trajectory analysis and simulations suggest that worker movement is consistent with two local mechanisms: one in which workers increase movement diffusivity outside their primary zone, and another in which workers modulate turning behaviour when approaching zone boundaries. Parallels with other organisms suggest that local mechanisms might represent a universal method for spatial partitioning in animal populations.

Financial technologies (FinTech) for mental health: The potential of objective financial data to better understand the relationships between financial behavior and mental health.

Financial stability is a key challenge for individuals with mental illnesses. Symptomatic periods often manifest in poor financial decision-making including compulsive spending and risky behaviors. This article explores research opportunities and challenges in developing financial technologies (FinTech) to support individuals with mental health. Specifically, we focus on how objective financial data might lead to novel mental health assessment and intervention methods. We have used data from one individual with bipolar disorder (BD) (i.e., an N = 1 case study) to illustrate feasibility of collecting and analyzing objective financial data alongside mental health factors. While we have not found statistically significant trends nor our findings are generalizable beyond this case, our approach provides an insight into the potential of using objective financial data to identify early warning signs and thereby, enable preemptive care for individuals with serious mental illnesses. We have also identified challenges of accessing objective financial data. The paper outlines what data is currently available, what can be done with it, and what factors to consider when working with financial data. We have also explored future directions for developing interventions to support financial well-being and stability. Furthermore, we have described the technical, ethical, and equity challenges for financial data-driven assessments and intervention methods, as well as provided a broad research agenda to address these challenges.