Developing local crisis leadership - A research and training agenda.

The crisis triggered by Covid-19 has exposed the interdependencies of modern society and sparked interest in local response to protracted and complex crisis situations. There has been a growing awareness and interest in the key roles of political and professional stakeholders, their emotional regulation and how they influence team performance and outcomes in dealing with uncertainty and complex crisis situations. While cognitive and behavioral aspects of crisis leadership are well researched, less is understood about how one can mitigate negative emotions, instill trust, or restore public faith and support of security forces and emergency response teams during crises. In addressing this gap, we propose a simplified conceptual roadmap for research and training of local crisis leadership. In this, we emphasize complex problem solving, team interaction, team context and technology and team training design. These four factors represent significant barriers if neglected. On the other side, they may be considerable force multipliers when better understood and managed. We suggest how seven research and training questions could be linked to the four conceptual factors and guide an evidence-based approach to develop local crisis leadership.

Impulse-Control Disorders in Parkinson's Disease: A Meta-Analysis and Review of Case-Control Studies.

BACKGROUND: Although several case-control studies on the prevalence of Impulse-Control Disorders (ICDs) in Parkinson's Disease (PD) have been conducted, no meta-analytic study on this topic has previously been published. Thus, knowledge about the overall prevalence rate of ICD in PD and factors that might moderate this relationship is lacking. METHOD: Prevalence studies of ICDs in PD were identified by computer searches in the MEDLINE, PsycINFO, and Web of Science databases, covering the period from January 2000 to February 2017. Data for N = 4,539, consisting of 2,371 PD patients and 2,168 healthy controls, representing 14 case-control studies were included. Estimation of the odds ratio (OR) of ICDs in PD compared to healthy controls was conducted using random-effects models. Mixed-effects models were applied in the moderator analysis of heterogeneity. Publication bias was estimated using a contour-enhanced funnel plot, the Rüker's test, and fail-safe N test for estimating the number of potential missing studies. RESULTS: Overall, the results showed significantly higher ratios for several ICDs in PD compared to healthy controls with the estimated overall ORs ranging between 2.07, 95% CI [1.26, 3.48], for having any ICDs, and 4.26, 95% CI [2.17, 8.36], for hypersexuality. However, the random-effects results for shopping were non-significant, though the fixed-effects model was significant (OR = 1.66, 95%CI [1.21, 2.27]). The testing of potential moderator variables of heterogeneity identified the following two variables that were both associated with increased risk: being medically treated for PD and disease duration. The results must be interpreted with some caution due to possible small-studies effect or publication bias. CONCLUSION: Individuals with PD seem to have a significantly greater risk of suffering from ICDs compared to healthy controls. Gambling, hypersexuality, eating, punding, and hobbying are all ICDs significantly associated with PDs being medically treated for PD.

Efficacy of fish intake on vitamin D status: a meta-analysis of randomized controlled trials.

BACKGROUND: It is well known that fish is the major natural source of vitamin D in the diet; therefore, this meta-analysis investigated the influence of fish consumption in randomized controlled trials (RCTs) on serum 25-hydroxyvitamin D [25(OH)D] concentrations. OBJECTIVE: A literature search was carried out in Medline, Embase, Web of Science, and the Cochrane Library (up to February 2014) for RCTs that investigated the effect of fish consumption on 25(OH)D concentrations in comparison to other dietary interventions. RESULTS: Seven articles and 2 unpublished study data sets with 640 subjects and 14 study groups met the inclusion criteria and were included in this meta-analysis. Compared with controls, the consumption of fish increased 25(OH)D concentrations, on average, by 4.4 nmol/L (95% CI: 1.7, 7.1 nmol/L; P < 0.0001, I(2) = 25%; 9 studies).The type of the fish also played a key role: the consumption of fatty fish resulted in a mean difference of 6.8 nmol/L (95% CI: 3.7, 9.9 nmol/L; P < 0.0001, I(2) = 0%; 7 study groups), whereas for lean fish the mean difference was 1.9 nmol/L (95% CI: -2.3, 6.0 nmol/L; P < 0.38, I(2) = 37%; 7 study groups). Short-term studies (4-8 wk) showed a mean difference of 3.8 nmol/L (95% CI: 0.6, 6.9 nmol/L; P < 0.02, I(2) = 38%; 10 study groups), whereas in long-term studies (∼6 mo) the mean difference was 8.3 nmol/L (95% CI: 2.1, 14.5 nmol/L; P < 0.009, I(2) = 0%; 4 study groups). CONCLUSION: As the major food source of vitamin D, fish consumption increases concentrations of 25(OH)D, although recommended fish intakes cannot optimize vitamin D status.

Music therapy for prisoners: pilot randomised controlled trial and implications for evaluating psychosocial interventions.

UNLABELLED: Mental health problems are common among prison inmates. Music therapy has been shown to reduce mental health problems. It may also be beneficial in the rehabilitation of prisoners, but rigorous outcome research is lacking. We compared group music therapy with standard care for prisoners in a pilot randomised controlled trial that started with the establishment of music therapy services in a prison near Bergen in 2008. In all, 113 prisoners agreed to participate. Anxiety (STAI-State [State-Trait Anxiety Inventory], STAI-Trait), depression (HADS-D [Hospital Anxiety and Depression Scale]), and social relationships (Quality of Life Enjoyment and Satisfaction Questionnaire [Q-LES-Q]) were assessed at baseline; every 2 weeks in the experimental group; after 1, 3, and 6 months in the control group; and at release. No restrictions were placed on the frequency, duration, or contents of music therapy. Duration of stay in the institution was short (62% stayed less than 1 month). Only a minority reached clinical cutoffs for anxiety and depression at baseline. Between-group analyses of effects were not possible. Music therapy was well accepted and attractive among the prisoners. Post hoc analysis of within-group changes suggested a reduction of state anxiety after 2 weeks of music therapy (d = 0.33, p = .025). Short sentences and low baseline levels of psychological disturbance impeded the examination of effects in this study. Recommendations for planning future studies are given, concerning the careful choice of participants, interventions and settings, comparison condition and design aspects, choice of outcomes, and integration of research approaches. Thus, the present study has important implications for future studies evaluating interventions for improving prisoners' mental health. TRIAL REGISTRATION: ISRCTN22518605.

Subjective sleep quality in relation to inhibition and heart rate variability in patients with panic disorder.

BACKGROUND: Patients with panic disorder (PD) are known to report impaired sleep quality and symptoms of insomnia. PD is an anxiety disorder characterised by deficient physiological regulation as measured by heart rate variability (HRV), and reduced HRV, PD and insomnia have all been related to impaired inhibitory ability. The present study aimed to investigate the interrelationships between subjectively reported sleep impairment, cognitive inhibition and vagally mediated HRV in a sample characterised by variability on measures of all these constructs. METHODS: Thirty-six patients with PD with or without agoraphobia were included. Cognitive inhibition was assessed with the Color-Word Interference Test from the Delis-Kaplan Executive Function System (D-KEFS), HRV was measured using high frequency (HF) power (ms(2)), and subjectively reported sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). RESULTS: Cognitive inhibition was related to both Sleep latency and Sleep disturbances, whereas HRV was only related to Sleep disturbances. These relationships were significant also after controlling for depression. LIMITATIONS: Correlational design. CONCLUSION: Cognitive inhibition is related to key insomnia symptoms: sleep initiation and sleep maintenance. The data supports the psychobiological inhibition model of insomnia, and extends previous findings. Possible clinical implications of these findings are discussed.

The relationships among heart rate variability, executive functions, and clinical variables in patients with panic disorder.

Heart rate variability (HRV) is reduced in patients who suffer from panic disorder (PD). Reduced HRV is related to hypoactivity in the prefrontal cortex (PFC), which negatively affects executive functioning. The present study assessed the relationships between vagally mediated HRV at baseline and measures of executive functioning in 36 patients with PD. Associations between these physiological and cognitive measures and panic-related variables were also investigated. HRV was measured using HF-power (ms(2)), and executive functions were assessed with the Wisconsin Card Sorting Test (WCST) and the Color-Word Interference Test (CWIT) from the Delis-Kaplan Executive Function System (D-KEFS). Panic-related variables comprised panic frequency, panic-related distress, and duration of PD. Performance on the neuropsychological measures correlated significantly with HRV. Both panic-related distress and duration of PD were inversely related with measures of HRV and cognitive inhibition. The current findings support the purported relationship between HRV and executive functions involving the PFC.

The relationship between attachment, personality and antisocial tendencies in a prison sample: a pilot study.

This study examined the role of adult attachment and personality in relation to antisocial tendencies (i.e. convictions for violence and interpersonal problems in romantic relationships) in Norwegian prison inmates (N=92). Attachment styles and personality were measured using self-report questionnaires (RSQ; Griffin & Bartholomew, 1994; and NEO-FFI, Costa & McCrae, 1992a). The prison inmates scored higher on avoidant than on anxious attachment style. While age and agreeableness (negatively associated) emerged as significant predictors of violence, anxious attachment explained most of the variances in aggression in intimate relationships. The study suggests that different types of antisocial tendencies could have different attachment and general personality correlates.

Relationship between heart rate variability and cognitive function during threat of shock.

The aim of the present study was to investigate the relationship between resting heart rate variability (HRV) and cognitive functions during threat of shock. A Continuous Performance Task and a Working Memory Task were used to measure cognitive functions. Sixty-five male participants from the Royal Norwegian Navy participated. HRV was measured during baseline, test conditions and recovery. Participants were randomly assigned into non-threat and threat groups. Based on the median split of the high frequency (HF) spectral power, groups were divided into two additional groups. Overall, the high HRV participants showed superior performance on cognitive tasks independent of non-threat or threat conditions. During threat condition the low HRV group showed improved performance. Thus, individuals with high HRV were more stress tolerant and resilient in the face of environmental changes. The results from the study might have implications with regard to performance in operational settings, but also for other fields of psychological research such as individual differences, anxiety and coping.

Brief communication: psychopathy and recognition of facial expressions of emotion.

This study investigated the relationship between symptom clusters of psychopathy, as measured by the Hare Psychopathy Checklist-Revised (PCL-R; Hare 1991), and ability to recognize facial expressions of emotion. Participants were 43 adult male inmates. Facial expressions of emotion were taken from Ekman and Frisen (1976). The present results indicated that there were some significant relationships between facets of psychopathy and processing of disgust facial expressions. The experiment highlighted the importance of studying specific clusters of psychopathic symptoms, as opposed to measures of global symptomatology.

Facets of psychopathy, heart rate variability and cognitive function.

The aim of the present study was to investigate whether the four facets of Hare's Psychopathy Checklist-Revised (PCL-R; Hare, 1991; Bolt, Hare, Vitale, & Newman, 2004) were related to physiological and cognitive mechanisms. Fifty-three male prisoners participated in this study. Physiological responses were measured as heart rate variability (HRV) and heart rate (HR). Cognitive functions were measured using a continuous performance test (CPT; California Computerized Assessment Package, Abbreviated version) and a working memory test (WMT); based on Baddeley & Hitch (1974). The regression analysis of the HRV revealed that the interpersonal facet explained most of the variance during baseline (28%), CPT (16%), and WMT (12%). This was also true for the HR data during baseline (28%), CPT (20%), WMT (10%), and recovery (13%). The antisocial facet explained 10% of the variance only during baseline. Subjects scoring high compared to low on the interpersonal facet also showed better cognitive functioning. The study suggests that the different facets were differently associated with both physiological and cognitive functions.

Heart rate variability and its relation to prefrontal cognitive function: the effects of training and detraining.

The aim of the present study was to investigate the relationship between physical fitness, heart rate variability (HRV) and cognitive function in 37 male sailors from the Royal Norwegian Navy. All subjects participated in an 8-week training program, after which the subjects completed the initial cognitive testing (pretest). The subjects were assigned into a detrained group (DG) and a trained group (TG) based on their application for further duty. The DG withdrew from the training program for 4 weeks after which all subjects then completed the cognitive testing again (post-test). Physical fitness, measured as maximum oxygen consumption (VO2(max)), resting HRV, and cognitive function, measured using a continuous performance task (CPT) and a working memory test (WMT), were recorded during the pre-test and the post-test, and the data presented as the means and standard deviations. The results showed no between-group differences in VO2(max) or HRV at the pre-test. The DG showed a significant decrease in VO2(max) from the pre- to the post-test and a lower resting HRV than the TG on the post-test. Whereas there were no between-group differences on the CPT or WMT at the pre-test, the TG had faster reaction times and more true positive responses on tests of executive function at the post-test compared to the pre-test. The DG showed faster reaction times on non-executive tasks at the post-test compared to the pre-test. The results are discussed within a neurovisceral integration framework linking parasympathetic outflow to the heart to prefrontal neural functions.

Vagal influence on working memory and attention.

The aim of the present study was to investigate the effect of vagal tone on performance during executive and non-executive tasks, using a working memory and a sustained attention test. Reactivity to cognitive tasks was also investigated using heart rate (HR) and heart rate variability (HRV). Fifty-three male sailors from the Royal Norwegian Navy participated in this study. Inter-beat-intervals were recorded continuously for 5 min of baseline, followed by randomized presentation of a working memory test (WMT) based on Baddeley and Hitch's research (1974) and a continuous performance test (CPT). The session ended with a 5-min recovery period. High HRV and low HRV groups were formed based on a median split of the root mean squared successive differences during baseline. The results showed that the high HRV group showed more correct responses than the low HRV group on the WMT. Furthermore, the high HRV group showed faster mean reaction time (mRT), more correct responses and less error, than the low HRV group on the CPT. Follow-up analysis revealed that this was evident only for components of the CPT where executive functions were involved. The analyses of reactivity showed a suppression of HRV and an increase in HR during presentation of cognitive tasks compared to recovery. This was evident for both groups. The present results indicated that high HRV was associated with better performance on tasks involving executive function.