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.

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).

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).

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.

This study aimed to refine the content of a new patient-reported outcome (PRO) measure via cognitive interviewing techniques to assess the unique presentation of depressive symptoms in older adults with cancer (OACs).

OACs (≥ 70years) with a history of a depressive disorder were administered a draft measure of the Older Adults with Cancer – Depression (OAC-D) Scale, then participated in a semi-structured cognitive interview to provide feedback on the appropriateness, comprehensibility, and overall acceptability of measure. Interviews were audio-recorded and transcribed, and qualitative methods guided revision of scale content and structure.

OACs (N = 10) with a range of cancer diagnoses completed cognitive interviews. Participants felt that the draft measure took a reasonable amount of time to answer and was easily understandable. They favored having item prompts and response anchors repeated with each item for ease of completion, and they helped identify phrasing and wording of key terms consistent with the authors’ intended constructs. From this feedback, a revised version of the OAC-D was created.

The OAC-D Scale is the first PRO developed specifically for use with OACs. The use of expert and patient input and rigorous cognitive interviewing methods provides a conceptually accurate means of assessing the unique symptom experience of OACs with depression.

To understand healthcare workers’ (HCWs) beliefs and practices toward blood culture (BCx) use.

Cross-sectional electronic survey and semi-structured interviews.

Academic hospitals in the United States.

HCWs involved in BCx ordering and collection in adult intensive care units (ICU) and wards.

We administered an anonymous electronic survey to HCWs and conducted semi-structured interviews with unit staff and quality improvement (QI) leaders in these institutions to understand their perspectives regarding BCx stewardship between February and November 2023.

Of 314 HCWs who responded to the survey, most (67.4%) were physicians and were involved in BCx ordering (82.3%). Most survey respondents reported that clinicians had a low threshold to culture patients for fever (84.4%) and agreed they could safely reduce the number of BCx obtained in their units (65%). However, only half of them believed BCx was overused. Although most made BCx decisions as a team (74.1%), a minority reported these team discussions occurred daily (42.4%). A third of respondents reported not usually collecting the correct volume per BCx bottle, half were unaware of the improved sensitivity of 2 BCx sets, and most were unsure of the nationally recommended BCx contamination threshold (87.5%). Knowledge regarding the utility of BCx for common infections was limited.

HCWs’ understanding of best collection practices and yield of BCx was limited.

Psychotic experiences (PEs) and social isolation (SI) seem related during early stages of psychosis, but the temporal dynamics between the two are not clear. Literature so far suggests a self-perpetuating cycle wherein momentary increases in PEs lead to social withdrawal, which, subsequently, triggers PEs at a next point in time, especially when SI is associated with increased distress. The current study investigated the daily-life temporal associations between SI and PEs, as well as the role of SI-related and general affective distress in individuals at clinical high risk (CHR) for psychosis.

We used experience sampling methodology in a sample of 137 CHR participants. We analyzed the association between SI, PEs, and distress using time-lagged linear mixed-effects models.

SI did not predict next-moment fluctuations in PEs, or vice versa. Furthermore, although SI-related distress was not predictive of subsequent PEs, general affective distress during SI was a robust predictor of next-moment PEs.

Our results suggest that SI and PEs are not directly related on a moment-to-moment level, but a negative emotional state when alone does contribute to the risk of PEs. These findings highlight the role of affective wellbeing during early-stage psychosis development.

The increasing complexity of social stress may be especially threatening to mental health during childhood and adolescence. One's skills in effectively coping with this stress may contribute to symptoms of pediatric anxiety and depression, a growing, significant, and pervasive public health concern. In addition to strategic skills, individual differences in coping may reflect differences in brain structure, including the white matter pathways that integrate frontal lobe networks with those involved in social functioning. Identifying the neurological substrates underlying anxiety and depression is an important way to delineate mechanisms underlying development of these disorders. Deterministic automated-fiber quantification (AFQ) is a technique that removes potential error from manual tracking of white matter, segregating tracts into distinct nodes—diminishing the effect of crossing fibers—and quantifying the number of fibers in a tract, allowing for assessment of connectivity across regions. Collectively, this investigation aims to quantify the interplay between anxiety, depression, coping with social stress, and white matter microstructure in children and adolescents.

Ninety-two healthy children and adolescents (8-17 years old; n=53 female, Mage=12.96; n=39 male, Mage=12.31) and a parent rated symptoms of anxiety and depression using the Behavior Assessment System for Children (BASC-III). Coping and stress reactivity were assessed using the Responses to Stress Questionnaire, Social Stress version. Children and adolescents also completed 64-direction DTI in a Siemens 3T Prisma scanner. White matter microstructure was quantified using AFQ; Fractional anisotropy (FA) values were extracted for 18 tracts, comprised of 100 nodes each.

Mean levels of parent- and self-reported anxiety and depression fell within the normative range, and children reported mild- to moderate social stress. Higher levels of social stress were associated with increased parent reported anxiety (r=.294, p=.002) and parent- and self-reported depression (r=.481, p<.001; r=.211, p=.034, respectively). Anxiety and depression were not significantly related to white matter microstructure; however, several specific links with coping were noted. Use of secondary control coping (e.g., cognitive restructuring) was associated with higher FA of the bilateral inferior fronto-occipital fasciculi (left IFOF r=.228, p=.027; right IFOF r=.299, p=.003) and left inferior longitudinal fasciculus (r=.269, p=.009); use of primary control coping (e.g., problem solving) was associated with higher FA of the bilateral uncinate fasciculi (left UF r=.216, p=.036; right UF r=.207, p=.045). Furthermore, use of primary and secondary control coping were associated with fewer symptoms of anxiety and depression, whereas greater use of disengagement coping (e.g., wishful thinking) was associated with more depressive symptoms.

These findings highlight links among white matter microstructure in tracts integrating frontal with temporal and occipital regions, and adoption of adaptive (i.e., primary and secondary control) coping responses. This may suggest that strong connections between brain regions supports more of a modulatory than a neglecting coping strategy. Finding also replicate extant literature on the ties between coping style and psychosocial distress. Given that coping responses are amenable to intervention, capitalizing on these brain-behavior links during ongoing neuromaturation is worthy of future research, with a goal of reducing symptoms of anxiety and depression via the brain's support of adaptive coping.