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42 Associations Between Mild Traumatic Brain Injury, Executive Function, and Criminal Justice Involvement among Veterans and Service Members: a LIMBIC-CENC study
- Becky K Gius, Lauren F. Fournier, Tea Reljic, Terri K. Pogoda, John D. Corrigan, Maya Troyanskaya, Cooper B. Hodges, Shannon R Miles, Amanda Garcia
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 148-150
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Objective:
To examine relationships between history of mild traumatic brain injury (mTBI), neuropsychological measures of executive function, and lifetime history of criminal justice (CJ) involvement among combat-exposed Veterans and Service Members (V/SM).
Participants and Methods:Participants were combat-exposed V/SM who completed a baseline assessment for the multicenter Long-term Impact of Military-Relevant Brain Injury Consortium - Chronic Effects of Neurotrauma Consortium study (N=1,341) and had adequate engagement/symptom reporting on measures of performance and symptom validity (i.e., Medical Symptom Validity Test and Mild Brain Injury Atypical Symptoms Scale). Neuropsychological battery included the Trail Making Test (A and B), Wechsler Adult Intelligence Scale-IV (WAIS-IV) Digit Span subtest, and the National Institute of Health (NIH) Toolbox Flanker subtest. Lifetime history of brain injury, criminal justice involvement, and demographics were collected. Participants were 87% male, 72% white, with a mean age of 40 years (SD=9.67). Eighty-one percent had at least some college education. Nineteen percent were active duty. Eighty percent of Veterans and 86% of Service Members reported a history of >1 mTBI, and of these 31% and 47% respectively experienced 3+ mTBIs.
Results:Three groups were composed based on level of involvement with the CJ system: 1.) No history of arrests or incarcerations (3+ mTBIs: 64%), 2.) A lifetime history of arrest but no felony incarceration (3+ mTBIs: 34%), and 3.) A lifetime history of felony incarceration (3+ mTBIs: 2%). Ordinal regression analyses revealed that performance on a working memory task (Digit Span; b= 0.024, p= .041; OR= 1.024) was significantly associated with increased CJ involvement after adjusting for age, education, service status, and mTBIs. Performance on measures of processing speed (Trails A), set-shifting (Trails B), and inhibition (Flanker) were not significantly associated with CJ involvement. Number of mTBIs was significantly and positively associated with level of CJ involvement in all four models; Digit Span (p= .016), Trails A (p= .016), Trails B (p= .020), and Flanker (p= .008).
Conclusions:Performance on most measures of executive functioning was not significantly associated with CJ involvement in this large, representative sample of V/SM who served in combat. Although performance on a working memory task was significantly associated with CJ involvement, the size of the effect was small and the association was in the opposite direction as expected. Number of mTBIs was significantly associated with level of CJ involvement, indicating that sustaining multiple mTBI may be linked to greater risk of CJ involvement. These findings suggest that social and psychological factors beyond executive dysfunction may better explain the relationship between history mTBIs and CJ involvement. Some aspects of military service and veteran status, such as interdisciplinary treatment for brain injury and physical, mental, and psychosocial health needs, may be protective against previously identified risk factors for arrest (e.g., deficits in executive functioning). Contextualizing mTBI within the larger behavioral health profile of V/SM, with emphasis placed on intervention for related co-morbidities, may reduce the impact of previous arrest on wellbeing and/or reduce the risk of future CJ involvement.
Influence of birth cohort on age of onset cluster analysis in bipolar I disorder
- M. Bauer, T. Glenn, M. Alda, O.A. Andreassen, E. Angelopoulos, R. Ardau, C. Baethge, R. Bauer, F. Bellivier, R.H. Belmaker, M. Berk, T.D. Bjella, L. Bossini, Y. Bersudsky, E.Y.W. Cheung, J. Conell, M. Del Zompo, S. Dodd, B. Etain, A. Fagiolini, M.A. Frye, K.N. Fountoulakis, J. Garneau-Fournier, A. Gonzalez-Pinto, H. Harima, S. Hassel, C. Henry, A. Iacovides, E.T. Isometsä, F. Kapczinski, S. Kliwicki, B. König, R. Krogh, M. Kunz, B. Lafer, E.R. Larsen, U. Lewitzka, C. Lopez-Jaramillo, G. MacQueen, M. Manchia, W. Marsh, M. Martinez-Cengotitabengoa, I. Melle, S. Monteith, G. Morken, R. Munoz, F.G. Nery, C. O’Donovan, Y. Osher, A. Pfennig, D. Quiroz, R. Ramesar, N. Rasgon, A. Reif, P. Ritter, J.K. Rybakowski, K. Sagduyu, A.M. Scippa, E. Severus, C. Simhandl, D.J. Stein, S. Strejilevich, A. Hatim Sulaiman, K. Suominen, H. Tagata, Y. Tatebayashi, C. Torrent, E. Vieta, B. Viswanath, M.J. Wanchoo, M. Zetin, P.C. Whybrow
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- Journal:
- European Psychiatry / Volume 30 / Issue 1 / January 2015
- Published online by Cambridge University Press:
- 15 April 2020, pp. 99-105
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Purpose:
Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onset, using a large, international database.
Methods:The database includes 4037 patients with a diagnosis of bipolar I disorder, previously collected at 36 collection sites in 23 countries. Generalized estimating equations (GEE) were used to adjust the data for country median age, and in some models, birth cohort. Model-based clustering (mixture analysis) was then performed on the age of onset data using the residuals. Clinical variables in subgroups were compared.
Results:There was a strong birth cohort effect. Without adjusting for the birth cohort, three subgroups were found by clustering. After adjusting for the birth cohort or when considering only those born after 1959, two subgroups were found. With results of either two or three subgroups, the youngest subgroup was more likely to have a family history of mood disorders and a first episode with depressed polarity. However, without adjusting for birth cohort (three subgroups), family history and polarity of the first episode could not be distinguished between the middle and oldest subgroups.
Conclusion:These results using international data confirm prior findings using single country data, that there are subgroups of bipolar I disorder based on the age of onset, and that there is a birth cohort effect. Including the birth cohort adjustment altered the number and characteristics of subgroups detected when clustering by age of onset. Further investigation is needed to determine if combining both approaches will identify subgroups that are more useful for research.
Personalized risk prediction of postoperative cognitive impairment – rationale for the EU-funded BioCog project
- G. Winterer, A. Fournier, O. Bender, D. Boraschi, F. Borchers, T.B. Dschietzig, I. Feinkohl, P. Fletcher, J. Gallinat, D. Hadzidiakos, J.D. Haynes, F. Heppner, S. Hetzer, J. Hendrikse, B. Ittermann, I.M.J. Kant, A. Kraft, A. Krannich, R. Krause, S. Kühn, G. Lachmann, S.J.T. van Montfort, A. Müller, P. Nürnberg, K. Ofosu, M. Pietsch, T. Pischon, J. Preller, E. Renzulli, K. Scheurer, R. Schneider, A.J.C. Slooter, C. Spies, E. Stamatakis, H.D. Volk, S. Weber, A. Wolf, F. Yürek, N. Zacharias, BioCog consortium
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- Journal:
- European Psychiatry / Volume 50 / April 2018
- Published online by Cambridge University Press:
- 01 January 2020, pp. 34-39
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Postoperative cognitive impairment is among the most common medical complications associated with surgical interventions – particularly in elderly patients. In our aging society, it is an urgent medical need to determine preoperative individual risk prediction to allow more accurate cost–benefit decisions prior to elective surgeries. So far, risk prediction is mainly based on clinical parameters. However, these parameters only give a rough estimate of the individual risk. At present, there are no molecular or neuroimaging biomarkers available to improve risk prediction and little is known about the etiology and pathophysiology of this clinical condition. In this short review, we summarize the current state of knowledge and briefly present the recently started BioCog project (Biomarker Development for Postoperative Cognitive Impairment in the Elderly), which is funded by the European Union. It is the goal of this research and development (R&D) project, which involves academic and industry partners throughout Europe, to deliver a multivariate algorithm based on clinical assessments as well as molecular and neuroimaging biomarkers to overcome the currently unsatisfying situation.
Study of pure and mixed clustered noble gas puffs irradiated with a high intensity (7 × 1019 W/cm2) sub-ps laser beam and achievement of a strong X-ray flash in a laser-generated debris-free X-ray source
- K. A. Schultz, V. L. Kantsyrev, A. S. Safronova, V. V. Shlyaptseva, E. E. Petkov, I. K. Shrestha, M. C. Cooper, G. M. Petrov, A. Stafford, C. J. Butcher, G. E. Kemp, J. Park, K. B. Fournier
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- Journal:
- Laser and Particle Beams / Volume 37 / Issue 3 / September 2019
- Published online by Cambridge University Press:
- 22 July 2019, pp. 276-287
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We present a broad study of linear, clustered, noble gas puffs irradiated with the frequency doubled (527 nm) Titan laser at Lawrence Livermore National Laboratory. Pure Ar, Kr, and Xe clustered gas puffs, as well as two mixed-gas puffs consisting of KrAr and XeKrAr gases, make up the targets. Characterization experiments to determine gas-puff density show that varying the experimental parameter gas-delay timing (the delay between gas puff initialization and laser-gas-puff interaction) provides a simple control over the gas-puff density. X-ray emission (>1.4 keV) is studied as a function of gas composition, density, and delay timing. Xe gas puffs produce the strongest peak radiation in the several keV spectral region. The emitted radiation was found to be anisotropic, with smaller X-ray flux observed in the direction perpendicular to both laser beam propagation and polarization directions. The degree of anisotropy is independent of gas target type but increases with photon energy. X-ray spectroscopic measurements estimate plasma parameters and highlight their difference with previous studies. Electron beams with energy in excess of 72 keV are present in the noble gas-puff plasmas and results indicate that Ar plays a key role in their production. A drastic increase in harder X-ray emissions (X-ray flash effect) and multi-MeV electron-beam generation from Xe gas-puff plasma occurred when the laser beam was focused on the front edge of the linear gas puff.
Behavioral and emotional dysregulation trajectories marked by prefrontal–amygdala function in symptomatic youth
- M. A. Bertocci, G. Bebko, T. Olino, J. Fournier, A. K. Hinze, L. Bonar, J. R. C. Almeida, S. B. Perlman, A. Versace, M. Travis, M. K. Gill, C. Demeter, V. A. Diwadkar, R. White, C. Schirda, J. L. Sunshine, L. E. Arnold, S. K. Holland, R. A. Kowatch, B. Birmaher, D. Axelson, E. A. Youngstrom, R. L. Findling, S. M. Horwitz, M. A. Fristad, M. L. Phillips
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- Journal:
- Psychological Medicine / Volume 44 / Issue 12 / September 2014
- Published online by Cambridge University Press:
- 27 January 2014, pp. 2603-2615
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Background
Neuroimaging measures of behavioral and emotional dysregulation can yield biomarkers denoting developmental trajectories of psychiatric pathology in youth. We aimed to identify functional abnormalities in emotion regulation (ER) neural circuitry associated with different behavioral and emotional dysregulation trajectories using latent class growth analysis (LCGA) and neuroimaging.
MethodA total of 61 youth (9–17 years) from the Longitudinal Assessment of Manic Symptoms study, and 24 healthy control youth, completed an emotional face n-back ER task during scanning. LCGA was performed on 12 biannual reports completed over 5 years of the Parent General Behavior Inventory 10-Item Mania Scale (PGBI-10M), a parental report of the child's difficulty regulating positive mood and energy.
ResultsThere were two latent classes of PGBI-10M trajectories: high and decreasing (HighD; n = 22) and low and decreasing (LowD; n = 39) course of behavioral and emotional dysregulation over the 12 time points. Task performance was >89% in all youth, but more accurate in healthy controls and LowD versus HighD (p < 0.001). During ER, LowD had greater activity than HighD and healthy controls in the dorsolateral prefrontal cortex, a key ER region, and greater functional connectivity than HighD between the amygdala and ventrolateral prefrontal cortex (p's < 0.001, corrected).
ConclusionsPatterns of function in lateral prefrontal cortical–amygdala circuitry in youth denote the severity of the developmental trajectory of behavioral and emotional dysregulation over time, and may be biological targets to guide differential treatment and novel treatment development for different levels of behavioral and emotional dysregulation in youth.
25 - Developing the Vision for EBM Governance in the Wider Caribbean
- Edited by Lucia Fanning, Robin Mahon, Patrick McConney, L. Verhart
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- Book:
- Towards Marine Ecosystem-Based Management in the Wider Caribbean
- Published by:
- Amsterdam University Press
- Published online:
- 22 January 2021
- Print publication:
- 15 July 2012, pp 355-366
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Summary
Introduction
Countries of the Wider Caribbean have committed to principled ocean governance through several multilateral environmental and fisheries agreements at both the regional (e.g., the Cartagena Convention SPAW Protocol) and international level (e.g., the Convention on Biological Diversity, the United Nations Fish Stocks Agreement, the FAO Code of Conduct for Responsible Fishing). They have also committed to the 2002 World Summit on Sustainable Development (WSSD) targets for fisheries and biodiversity conservation. However, the ongoing challenge is to put in place the measures required to give effect to these principles at the local, national and regional levels (Fanning et al. 2009). While not minimising the important role of science in an ecosystem approach to managing the living marine resources of the Wider Caribbean Region, the chapters in this book serve to highlight the importance that regional experts have placed on the role of governance to address the problems in the region.
This synthesis chapter presents the outputs of a discussion specifically relating to the role of governance in achieving and implementing a shared vision for ecosystem-based management (EBM) in the Wider Caribbean, using the process described in Chapter 1. In terms of structure, the chapter first describes a vision for governance and reports on the priorities assigned to the identified vision elements. It then discusses how the vision might be achieved by taking into account assisting factors (those that facilitate achievement) and resisting factors (those that inhibit achievement). The chapter concludes with guidance on the strategic direction needed to implement the vision, identifying specific actions to be undertaken for each of the vision elements.
The Vision
The occupational breakdown of members of the Governance Working Group reflected the diversity of affiliations present at the EBM Symposium and included governmental, intergovernmental, academic, non-governmental and private sector (fishers and fishing industry and consulting) representatives. With guidance provided by the facilitator, this diverse grouping of participants was asked to first address the question: “What do you see in place in 10 years’ time when EBM/EAF has become a reality in the Caribbean?”. This diversity provided for a fruitful and comprehensive visioning process, the results of which are summarised in Table 25.1, in terms of the key vision elements and their subcomponents, and in Figure 25.1, which illustrates the level of priority assigned to each of the vision elements.