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Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
Treatment guidelines recommend evidence-based psychological therapies for adults with intellectual disabilities with co-occurring anxiety or depression. No previous research has explored the effectiveness of these therapies in mainstream psychological therapy settings or outside specialist settings.
Aims
To evaluate the effectiveness of psychological therapies delivered in routine primary care settings for people with intellectual disability who are experiencing co-occurring depression or anxiety.
Method
This study used linked electronic healthcare records of 2 048 542 adults who received a course of NHS Talking Therapies for anxiety and depression in England between 2012 and 2019 to build a retrospective, observational cohort of individuals with intellectual disability, matched 1:2 with individuals without intellectual disability. Logistic regressions were used to compare metrics of symptom improvement and deterioration used in the national programme, on the basis of depression and anxiety measures collected before and at the last attended therapy session.
Results
The study included 6870 adults with intellectual disability and 2 041 672 adults without intellectual disability. In unadjusted analyses, symptoms improved on average for people with intellectual disability after a course of therapy, but these individuals experienced poorer outcomes compared with those without intellectual disability (reliable improvement 60.2% for people with intellectual disability v. 69.2% for people without intellectual disability, odds ratio 0.66, 95% CI 0.63–0.70; reliable deterioration 10.3% for people with intellectual disability v. 5.7% for those without intellectual disability, odds ratio 1.89, 95% CI 1.75–2.04). After propensity score matching, some differences were attenuated (reliable improvement, adjusted odds ratio 0.97, 95% CI 1.91–1.04), but some outcomes remained poorer for people with intellectual disability (reliable deterioration, adjusted odds ratio 1.28, 95% CI 1.16–1.42).
Conclusions
Evidence-based psychological therapies may be effective for adults with intellectual disability, but their outcomes may be similar to (for improvement and recovery) or poorer than (for deterioration) those for adults without intellectual disability. Future work should investigate the impact of adaptations of therapies for those with intellectual disability to make such interventions more effective and accessible for this population.
Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.
This study explores the impact of heatwaves on emergency calls for assistance resulting in service attendance in the Australian state of Queensland for the period from January 1, 2010 through December 31, 2019. The study uses data from the Queensland Ambulance Service (QAS), a state-wide prehospital health system for emergency health care.
Methods:
A retrospective case series using de-identified data from QAS explored spatial and demographic characteristics of patients attended by ambulance and the reason for attendance. All individuals for which there was an emergency call to “000” that resulted in ambulance attendance in Queensland across the ten years were captured. Demand for ambulance services during heatwave and non-heatwave periods were compared. Incidence rate ratio (IRR) and 95% confidence intervals (CI) were constructed exploring ambulance usage patterns during heatwaves and by rurality, climate zone, age groups, sex, and reasons for attendance.
Results:
Compared with non-heatwave days, ambulance attendance across Queensland increased by 9.3% during heatwave days. The impact of heatwaves on ambulance demand differed by climate zone (high humidity summer with warm winter; hot dry summer with warm winter; warm humid summer with mild winter). Attendances related to heat exposure, dehydration, alcohol/drug use, and sepsis increased substantially during heatwaves.
Conclusion:
Heatwaves are a driver of increased ambulance demand in Queensland. The data raise questions about climatic conditions and heat tolerance, and how future cascading and compounding heat disasters may influence work practices and demands on the ambulance service. Understanding the implications of heatwaves in the prehospital setting is important to inform community, service, and system preparedness.
Globally, considerable attention is being given to the multifaceted challenges that policing faces as part of the United Nations 2030 Agenda for Sustainable Development. Goal 16 of the Sustainable Development Goals (SDGs) refers to promoting peace, security, human rights, stability and effective governance based on the rule of law. However, policing Nigeria to meet this goal has been fraught with several challenges, which range from erosion of public trust to growing crime rate, police brutality and other misconduct. This article reviewed empirical studies on how legitimacy issues impacted police enforcement of COVID-19 protocols and lockdown rules in Nigeria. Leaning on legitimacy and procedural justice theories, a systematic and iterative approach was adopted to identify and synthesize relevant literature on pandemic policing in Nigeria. We searched 12 databases (Scopus, PsycINFO, AJOL, Sage Journals Online, Web of Science, Academic Search Ultimate, PAIS Index, ProQuest Sociology, HeinOnline, Criminal Justice Abstracts, JSTOR, Sociological Abstracts) for empirical studies on pandemic policing in Nigeria published between 2020 and 2024. A total of 11 studies were included in the review. Four main themes were identified: the Nigerian police pre-COVID legitimacy issues; police enforcement of lockdown rules; key challenges; and lessons for post-pandemic policing. The review highlights the pre-COVID legitimacy issues of the Nigerian police that made an impact on public trust and cooperation during the lockdown period and recommends strategies to assist the Nigerian police in building momentum for a systemic and stylistic change of policing from force-based to consent-based.
Contemporary racial theorization about American society assumes the universality of White dominance as its point of departure. We argue here that Hawai‘i is an exception, where White supremacy has given way to a multiracial mainstream, shared by the Chinese, Japanese, and Whites. This was a surprising development in a state founded in settler colonialism and racial capitalism, which was moreover a racially hierarchical plantation society until the middle of the twentieth century. The pivot, in Hawai‘i as on the mainland, occurred during the post-World War II period, when the economy underwent a transformation requiring a more educated workforce. On the mainland, this socioeconomic shift opened up the mainstream to the so-called White ethnics. But these were few in number in Hawai‘i, and so the Chinese and Japanese ascended socioeconomically and socially instead. The ethnoracial hierarchy created in this period is still in evidence, as shown by pronounced inequalities among Hawaiian groups. However, the end of White supremacy has been associated with very widespread ethnoracial mixing in families. We discuss some ways in which Hawai‘i may offer a preview of twenty-first-century changes in the U.S. as a whole.
It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.
Aims
To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.
Method
Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.
Results
IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).
Conclusions
Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.
Aerosol-cloud interactions contribute significant uncertainty to modern climate model predictions. Analysis of complex observed aerosol-cloud parameter relationships is a crucial piece of reducing this uncertainty. Here, we apply two machine learning methods to explore variability in in-situ observations from the NASA ACTIVATE mission. These observations consist of flights over the Western North Atlantic Ocean, providing a large repository of data including aerosol, meteorological, and microphysical conditions in and out of clouds. We investigate this dataset using principal component analysis (PCA), a linear dimensionality reduction technique, and an autoencoder, a deep learning non-linear dimensionality reduction technique. We find that we can reduce the dimensionality of the parameter space by more than a factor of 2 and verify that the deep learning method outperforms a PCA baseline by two orders of magnitude. Analysis in the low dimensional space of both these techniques reveals two consistent physically interpretable regimes—a low pollution regime and an in-cloud regime. Through this work, we show that unsupervised machine learning techniques can learn useful information from in-situ atmospheric observations and provide interpretable results of low-dimensional variability.
Though formal life sentences have been abolished in Norway, forvaring (post-conviction indefinite preventive detention) – a type of informal life sentence – can be imposed on individuals convicted of certain offenses who are considered to be at high risk of future offending. While great attention has been paid to Norway as an “exceptional” penal outlier globally, there is a notable lack of comprehensive knowledge about its indefinite penal sanction. Drawing on extensive historical research and legal and policy documentary analysis as well as leveraging a unique national dataset on the total forvaring population, this article provides the first international in-depth assessment of the evolution and implementation of Norway’s ultimate penalty. In so doing, it highlights significant disparities between policy ambitions and current practice and questions the extent to which the sanction of forvaring can be considered an “exceptional” approach to life imprisonment. It is argued that the development and growth of this type of informal life sentence can be seen as the epicenter of the impact of a more punitive ideology in Norway, emphasizing the need to move away from the concept of penal exceptionalism to better understand the full spectrum and practice of Norwegian and Nordic penality.
Changing sea-ice conditions have significant societal impacts and implications across Alaska and the Arctic. This research examined the relationship between sea ice and extreme weather events with socio-economic impacts in Nome, Alaska (1990–2020), a community that has experienced notable changes in sea ice and impacts from extreme weather events. The research is based on the analysis of sea-ice concentrations from passive microwave data, socio-economic impacts of extreme weather events from an archival analysis of newspaper coverage, and an examination of the relationship between sea-ice concentrations and impacts. We found that sea-ice concentrations at the time of the reported socio-economic impacts were all characterised by ice-free conditions. Additionally, extreme events linked to socio-economic impacts occurred when sea-ice concentrations were at or below their historical (1979–2000) median for the day. Key implications for the observed increased probability of ice-free conditions in the autumn include a greater likelihood that a given coastal storm from November to mid-December may contribute to socio-economic impacts, which may have been mitigated by sea ice in the past, as well as an increased potential for impacts to occur when they have previously not been experienced.
Ultrasound-guided wire localisation may improve intra-operative identification and outcomes of non-palpable cervical lymphadenopathy in a previously treated neck. We undertook a literature search and present our case series to determine the safety and efficacy of ultrasound-guided wire localisation.
Methods
A search of databases up to 29 April 2024 was performed. At our tertiary centre, ultrasound-guided wire localisation was utilised for 20 patients with cervical lymphadenopathy between February 2021 and April 2024.
Results
Seventeen studies with a combined total of 92 patients were identified, with one complication reported. Within our case series, all 20 patients had accurate lesion localisation using ultrasound-guided wire localisation and none required repeat operations.
Conclusion
Ultrasound-guided wire localisation is a safe and cost-effective technique for lesions in an otherwise difficult area to operate, providing confidence to the multidisciplinary team, particularly where histopathology indicates benignity. Surgical outcomes do not appear worse than outcomes without ultrasound-guided wire localisation. We advocate its use provided appropriate patient selection is considered.
Maladaptive daydreaming is a distinct syndrome in which the main symptom is excessive vivid fantasising that causes clinically significant distress and functional impairment in academic, vocational and social domains. Unlike normal daydreaming, maladaptive daydreaming is persistent, compulsive and detrimental to one’s life. It involves detachment from reality in favour of intense emotional engagement with alternative realities and often includes specific features such as psychomotor stereotypies (e.g. pacing in circles, jumping or shaking one’s hands), mouthing dialogues, facial gestures or enacting fantasy events. Comorbidity is common, but existing disorders do not account for the phenomenology of the symptoms. Whereas non-specific therapy is ineffective, targeted treatment seems promising. Thus, we propose that maladaptive daydreaming be considered a formal syndrome in psychiatric taxonomies, positioned within the dissociative disorders category. Maladaptive daydreaming satisfactorily meets criteria for conceptualisation as a psychiatric syndrome, including reliable discrimination from other disorders and solid interrater agreement. It involves significant dissociative aspects, such as disconnection from perception, behaviour and sense of self, and has some commonalities with but is not subsumed under existing dissociative disorders. Formal recognition of maladaptive daydreaming as a dissociative disorder will encourage awareness of a growing problem and spur theoretical, research and clinical developments.
Online labor markets have great potential as platforms for conducting experiments. They provide immediate access to a large and diverse subject pool, and allow researchers to control the experimental context. Online experiments, we show, can be just as valid—both internally and externally—as laboratory and field experiments, while often requiring far less money and time to design and conduct. To demonstrate their value, we use an online labor market to replicate three classic experiments. The first finds quantitative agreement between levels of cooperation in a prisoner's dilemma played online and in the physical laboratory. The second shows— consistent with behavior in the traditional laboratory—that online subjects respond to priming by altering their choices. The third demonstrates that when an identical decision is framed differently, individuals reverse their choice, thus replicating a famed Tversky-Kahneman result. Then we conduct a field experiment showing that workers have upward-sloping labor supply curves. Finally, we analyze the challenges to online experiments, proposing methods to cope with the unique threats to validity in an online setting, and examining the conceptual issues surrounding the external validity of online results. We conclude by presenting our views on the potential role that online experiments can play within the social sciences, and then recommend software development priorities and best practices.
We conducted the first randomized controlled field experiment of an Internet reputation mechanism. A high-reputation, established eBay dealer sold matched pairs of lots— batches of vintage postcards—under his regular identity and under new seller identities (also operated by him). As predicted, the established identity fared better. The difference in buyers’ willingness-to-pay was 8.1% of the selling price. A subsidiary experiment followed the same format, but compared sales by relatively new sellers with and without negative feedback. Surprisingly, one or two negative feedbacks for our new sellers did not affect buyers’ willingness-to-pay.
We apply moral foundations theory (MFT) to explore how the public conceptualizes the first eight months of the conflict between Ukraine and the Russian Federation (Russia). Our analysis includes over 1.1 million English tweets related to the conflict over the first 36 weeks. We used linguistic inquiry word count (LIWC) and a moral foundations dictionary to identify tweets’ moral components (care, fairness, loyalty, authority, and sanctity) from the United States, pre- and post-Cold War NATO countries, Ukraine, and Russia. Following an initial spike at the beginning of the conflict, tweet volume declined and stabilized by week 10. The level of moral content varied significantly across the five regions and the five moral components. Tweets from the different regions included significantly different moral foundations to conceptualize the conflict. Across all regions, tweets were dominated by loyalty content, while fairness content was infrequent. Moral content over time was relatively stable, and variations were linked to reported conflict events.
Monumental roads were constructed during the ninth to thirteenth centuries by the regional society centred on Chaco Canyon in the US Southwest. Here, the authors present new lidar and field documentation of parallel roads at the Gasco Site, which sits within a ritual landscape south of Chaco Canyon. Their findings reveal that the Gasco Road is substantially longer than previously believed and forms alignments between natural springs and towards the winter solstice sunrise over Mount Taylor, a mountain sacred among contemporary Indigenous peoples. These findings highlight the agency of landscapes and skyscapes in structuring ritual practices in ancient societies worldwide.
Obruchevodid petalodonts are rare small chondrichthyans known from nearly complete to partial skeletons from the Upper Mississippian (Serpukhovian) Bear Gulch Limestone of central Montana and isolated teeth from the Upper Mississippian Bangor Limestone of northern Alabama. New records of obruchevodid petalodonts are presented here from the Middle Mississippian (Viséan) Joppa Member of the Ste. Genevieve Formation at Mammoth Cave National Park, Kentucky. Obruchevodids are here represented by multiple teeth of a new taxon, Clavusodens mcginnisi n. gen. n. sp., and a single tooth referred to ?Netsepoye sp. Clavusodens mcginnisi n. gen. n. sp. is characterized by teeth with pointed mesiodistal and lingual margins and more robust chisel-like cusps on the anterolateral and distolateral teeth. The suggestion that obruchevodid petalodonts evolved to inhabit complex reef-like environments and other nearshore habitats with a feeding ecology analogous to extant triggerfish is explored and discussed.
Observation of thin sections of the WAIS (West Antarctic Ice Sheet) Divide ice core in cross-polarized light reveals a wealth of microstructures and textural characteristics indicative of strain and recovery in an anisotropic crystalline substance undergoing high-temperature plastic deformation. The appearance of abundant subgrain domains—relatively strain-free regions inside crystals (grains) surrounded by walls of dislocations across which small structural orientation changes occur—is particularly noticeable in the depth range associated with the brittle ice (∼650–1300 m). Here we describe a subgrain texture, not previously reported in ice, that resembles chessboard-pattern subgrains in β-quartz. This chessboard texture at WAIS Divide is strongly associated with the presence of bubbles. We hypothesize that chessboard-subgrain development may affect grain-size evolution, the fracture of ice cores recovered from the brittle ice zone and perhaps grain-boundary sliding as well.