The association between childhood trauma and emotion recognition is reduced or eliminated when controlling for alexithymia and psychopathy traits.

Emotion recognition shows large inter-individual variability, and is substantially affected by childhood trauma as well as modality, emotion portrayed, and intensity. While research suggests childhood trauma influences emotion recognition, it is unclear whether this effect is consistent when controlling for interrelated individual differences. Further, the universality of the effects has not been explored, most studies have not examined differing modalities or intensities. This study examined childhood trauma's association with accuracy, when controlling for alexithymia and psychopathy traits, and if this varied across modality, emotion portrayed, and intensity. An adult sample (N = 122) completed childhood trauma, alexithymia, and psychopathy questionnaires and three emotion tasks: faces, voices, audio-visual. When investigating childhood trauma alone, there was a significant association with poorer accuracy when exploring modality, emotion portrayed, and intensity. When controlling for alexithymia and psychopathy, childhood trauma remained significant when exploring emotion portrayed, however, it was no longer significant when exploring modality and intensity. In fact, alexithymia was significant when exploring intensity. The effect sizes overall were small. Our findings suggest the importance of controlling for interrelated individual differences. Future research should explore more sensitive measures of emotion recognition, such as intensity ratings and sensitivity to intensity, to see if these follow accuracy findings.

The effects of face coverings, own-ethnicity biases, and attitudes on emotion recognition.

As a result of the COVID-19 pandemic, face coverings were introduced as a safety measure in certain environments in England and some research suggests that they can affect emotion recognition. Factors such as own-ethnicity bias (e.g. whether people perceiving and expressing emotions are of the same ethnicity) and social biases are also known to influence emotion recognition. However, it is unclear whether these factors interact with face coverings to affect emotion recognition. Therefore, this study examined the effects of face coverings, own-ethnicity biases, and attitudes on emotion recognition accuracy. In this study, 131 participants viewed masked and unmasked emotional faces varying in ethnicity and completed a questionnaire on their attitudes towards face masks. We found that emotion recognition was associated with masks and attitudes: accuracy was lower in masked than unmasked conditions and attitudes towards masks Inside and Outside were associated with emotion recognition. However, a match between perceiver and stimulus ethnicity did not have a significant effect on emotion recognition. Ultimately, our results suggest that masks, and negative attitudes towards them, were associated with poorer emotion recognition. Future research should explore different mask-wearing behaviours and possible in-group/out-group biases and their interaction with other social cues (e.g. in-group biases).

Fertility preservation in transgender and non-binary adolescents and young adults.

Although 37.5-51% of transgender adults state they would've considered freezing gametes before gender-affirming therapy if offered and 24-25.8% of transgender adolescents express interest in having biological children, less than 5% of transgender adolescents have opted for fertility preservation. We sought to assess fertility preservation utilization in our multidisciplinary adolescent gender clinic. We also aimed to identify fertility preservation utilization and interest among non-binary adolescents and young adults. A retrospective review was conducted of patients seen in the Stanford Pediatric & Adolescent Gender Clinic from October 2015 through March 2019 who were >10 years of age at initial visit. All individuals with documented discussion of fertility preservation were offered referral for formal fertility preservation consultation but only 24% of patients accepted. Only 6.8% of individuals subsequently underwent fertility preservation (n = 9). Transfeminine adolescents are more likely to pursue fertility preservation than transmasculine adolescents (p = 0.01). The rate of fertility preservation in non-binary adolescents did not significantly differ from those in transfeminine adolescents (p = 1.00) or transmasculine adolescents (p = 0.31). Although only one non-binary individual underwent fertility preservation, several more expressed interest with 36% accepting referral (n = 4) and 27% being seen in consultation (n = 3). Despite offering fertility preservation with designated members of a gender clinic team, utilization remains low in transgender adolescents. Additionally, non-binary adolescents and their families are interested in fertility preservation and referrals should be offered to these individuals. Further studies and advocacy are required to continue to address fertility needs of transgender adolescents.

Gradient washout and secondary nephrogenic diabetes insipidus after brain injury in an infant: a case report.

BACKGROUND: Disorders of water and sodium balance can occur after brain injury. Prolonged polyuria resulting from central diabetes insipidus and cerebral salt wasting complicated by gradient washout and a type of secondary nephrogenic diabetes insipidus, however, has not been described previously, to the best of our knowledge. We report an unusual case of an infant with glioblastoma who, after tumor resection, was treated for concurrent central diabetes insipidus and cerebral salt wasting complicated by secondary nephrogenic diabetes insipidus. CASE PRESENTATION: A 5-month-old Hispanic girl was found to have a large, hemorrhagic, suprasellar glioblastoma causing obstructive hydrocephalus. Prior to mass resection, she developed central diabetes insipidus. Postoperatively, she continued to have central diabetes insipidus and concurrent cerebral salt wasting soon after. She was managed with a vasopressin infusion, sodium supplementation, fludrocortisone, and urine output replacements. Despite resolution of her other major medical issues, she remained in the pediatric intensive care unit for continual and aggressive management of water and sodium derangements. Starting on postoperative day 18, her polyuria began increasing dramatically and did not abate with increasing vasopressin. Nephrology was consulted. Her blood urea nitrogen was undetectable during this time, and it was thought that she may have developed a depletion of inner medullary urea and osmotic gradient: a "gradient washout." Supplemental dietary protein was added to her enteral nutrition, and her fluid intake was decreased. Within 4 days, her blood urea nitrogen increased, and her vasopressin and fluid replacement requirements significantly decreased. She was transitioned soon thereafter to subcutaneous desmopressin and transferred out of the pediatric intensive care unit. CONCLUSIONS: Gradient washout has not been widely reported in humans, although it has been observed in the mammalian kidneys after prolonged polyuria. Although not a problem with aquaporin protein expression or production, gradient washout causes a different type of secondary nephrogenic diabetes insipidus because the absence of a medullary gradient impairs water reabsorption. We report a case of an infant who developed complex water and sodium imbalances after brain injury. Prolonged polyuria resulting from both water and solute diuresis with low enteral protein intake was thought to cause a urea gradient washout and secondary nephrogenic diabetes insipidus. The restriction of fluid replacements and supplementation of enteral protein appeared adequate to restore the renal osmotic gradient and efficacy of vasopressin.

Building an Effective Medico-Legal Intervention Model in post-Earthquake Haiti / Construcción de un modelo de intervención médico-legal efectivo tras el terremoto en Haití

The earthquake that struck Haiti on January 12, 2010 left the country and its people devastated, with overwhelming losses, death, homelessness and increased violence and safety concerns. This study proposes an effective intervention model for facilitating humanitarian parole for survivors of the earthquake. A medico-legal team of psychiatrists and human rights and immigration evaluated traumatized individuals and families in Port-au-Prince in March 2010. With support from local NGOs, the legal team screened and prioritized the most severe cases, and the medical team assessed individuals with acute medical and psychiatric concerns. 124 cases were screened for humanitarian parole. Psychological, psychiatric and medical assessments were completed in 48 families (68 individuals) to identify orphans and vulnerable children, survivors of past violence who faced a risk of re-traumatization, and those at high-risk of psychological trauma. All cases needed shelter, clean water and food. Mental health impairment beyond loss and grief were identified in 89.7% of cases. Our findings suggest that a multi-disciplinary, community-based model is effective in identifying individuals and families that meet the conceptual criteria for Humanitarian Parole. The model is also effective in identifying the psychosocial and medical needs of survivors and assisting them in receiving essential health services

El terremoto que azotó Haití el 12 de Enero de 2010 dejó devastados al país y a su gente, con abrumadoras preocupaciones en torno a la pérdida, la muerte, el aumento de la violencia y la seguridad. Este estudio propone un modelo de intervención efectivo para proporcionar refugio humanitario en EE.UU. a los supervivientes del terremoto. Un equipo médico-legal de psiquiatras, personal de inmigración, y de derechos humanos, evaluó a los individuos traumatizados y a sus familias en Puerto Príncipe en Marzo de 2010. con el apoyo de ONGs locales, el equipo legal valoró y priorizó los casos más graves, y el equipo médico evaluó a los individuos con problemas médicos y psiquiátricos. Se seleccionaron 124 casos para proporcionarles refugio humanitario en EE.UU. Se completaron las valoraciones psicológica, psiquiátrica y médica en 48 familias (68 individuos), con el fin de identificar niños huérfanos y vulnerables, supervivientes de violencia pasada con riesgo de nueva traumatización, y persona de alto riesgo de trauma psicológico. Todos los casos necesitaban albergue, agua limpia y comida. Se identificó desajuste mental más allá del propio de la pérdida y el duelo en un 89,7% de los casos. Nuestros hallazgos sugieren que un modelo multidisciplinar, basado en la comunidad, es efectivo para identificar las necesidades psicológicas y médicas de los supervivientes y asistirles para recibir servicios sanitarios esenciales