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Ten new insights in climate science 2023
- Mercedes Bustamante, Joyashree Roy, Daniel Ospina, Ploy Achakulwisut, Anubha Aggarwal, Ana Bastos, Wendy Broadgate, Josep G. Canadell, Edward R. Carr, Deliang Chen, Helen A. Cleugh, Kristie L. Ebi, Clea Edwards, Carol Farbotko, Marcos Fernández-Martínez, Thomas L. Frölicher, Sabine Fuss, Oliver Geden, Nicolas Gruber, Luke J. Harrington, Judith Hauck, Zeke Hausfather, Sophie Hebden, Aniek Hebinck, Saleemul Huq, Matthias Huss, M. Laurice P. Jamero, Sirkku Juhola, Nilushi Kumarasinghe, Shuaib Lwasa, Bishawjit Mallick, Maria Martin, Steven McGreevy, Paula Mirazo, Aditi Mukherji, Greg Muttitt, Gregory F. Nemet, David Obura, Chukwumerije Okereke, Tom Oliver, Ben Orlove, Nadia S. Ouedraogo, Prabir K. Patra, Mark Pelling, Laura M. Pereira, Åsa Persson, Julia Pongratz, Anjal Prakash, Anja Rammig, Colin Raymond, Aaron Redman, Cristobal Reveco, Johan Rockström, Regina Rodrigues, David R. Rounce, E. Lisa F. Schipper, Peter Schlosser, Odirilwe Selomane, Gregor Semieniuk, Yunne-Jai Shin, Tasneem A. Siddiqui, Vartika Singh, Giles B. Sioen, Youba Sokona, Detlef Stammer, Norman J. Steinert, Sunhee Suk, Rowan Sutton, Lisa Thalheimer, Vikki Thompson, Gregory Trencher, Kees van der Geest, Saskia E. Werners, Thea Wübbelmann, Nico Wunderling, Jiabo Yin, Kirsten Zickfeld, Jakob Zscheischler
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- Journal:
- Global Sustainability / Volume 7 / 2023
- Published online by Cambridge University Press:
- 01 December 2023, e19
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Non-technical summary
We identify a set of essential recent advances in climate change research with high policy relevance, across natural and social sciences: (1) looming inevitability and implications of overshooting the 1.5°C warming limit, (2) urgent need for a rapid and managed fossil fuel phase-out, (3) challenges for scaling carbon dioxide removal, (4) uncertainties regarding the future contribution of natural carbon sinks, (5) intertwinedness of the crises of biodiversity loss and climate change, (6) compound events, (7) mountain glacier loss, (8) human immobility in the face of climate risks, (9) adaptation justice, and (10) just transitions in food systems.
Technical summaryThe Intergovernmental Panel on Climate Change Assessment Reports provides the scientific foundation for international climate negotiations and constitutes an unmatched resource for researchers. However, the assessment cycles take multiple years. As a contribution to cross- and interdisciplinary understanding of climate change across diverse research communities, we have streamlined an annual process to identify and synthesize significant research advances. We collected input from experts on various fields using an online questionnaire and prioritized a set of 10 key research insights with high policy relevance. This year, we focus on: (1) the looming overshoot of the 1.5°C warming limit, (2) the urgency of fossil fuel phase-out, (3) challenges to scale-up carbon dioxide removal, (4) uncertainties regarding future natural carbon sinks, (5) the need for joint governance of biodiversity loss and climate change, (6) advances in understanding compound events, (7) accelerated mountain glacier loss, (8) human immobility amidst climate risks, (9) adaptation justice, and (10) just transitions in food systems. We present a succinct account of these insights, reflect on their policy implications, and offer an integrated set of policy-relevant messages. This science synthesis and science communication effort is also the basis for a policy report contributing to elevate climate science every year in time for the United Nations Climate Change Conference.
Social media summaryWe highlight recent and policy-relevant advances in climate change research – with input from more than 200 experts.
Personality Functioning and Self-Disorders in different stages of Psychotic Disorders and Borderline Personality Disorder
- M. Gruber, J. Alexopoulos, K. Feichtinger, K. Parth, A. Wininger, N. Mossaheb, F. Friedrich, Z. Litvan, B. Hinterbuchinger, S. Doering, V. Blüml
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S449
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Introduction
Personality functioning, self-disorders and their relationship to psychotic symptoms on a continuum from mild attenuated experiences to manifest psychotic symptoms in psychotic disorders are highly relevant for psychopathology, course of illness and treatment planning in psychotic disorders, but empirical data is sparse.
ObjectivesThis study aims at exploring personality functioning and self-disorders in individuals at ultra-high risk for psychosis (UHR) and with first-episode psychosis (FEP), compared to a clinical control group of subjects with borderline personality disorder (BPD) and healthy controls (HC).
MethodsPersonality functioning was measured in 107 participants (24 UHR, 29 FEP, and 27 BPD and 27 HC) using the Structured Interview for Personality Organization (STIPO) and the Level of Personality Functioning Scale (LPFS), and self-disorders were assessed using the Examination of Anomalous Self-Experience (EASE). A hierarchical cluster analysis was performed based on the seven STIPO dimensions.
ResultsSignificant impairment in personality functioning was found in UHR (M = 4.29, SD = .908), FEP (M = 4.83, SD = 1.002), and BPD individuals (M=4.70, SD=.542) compared with HC (M = 1.63, SD = .565). FEP patients showed significantly worse overall personality functioning compared to UHR patients (p = .037). Patients with manifest psychosis (FEP) also exhibited significantly higher levels of self-disorders compared to BPD patients (p = .019). Self-disturbances in patients with milder forms of psychotic symptoms (UHR) were intermediate between the other diagnostic groups (FEP and BPD). Regardless of the main diagnoses, the three clusters of patients were found to differ in levels of personality functioning and self-disorder.
ConclusionsImpairment of personality functioning varies in different stages of psychotic disorders. The level of self-disorders may allow differentiation between manifest psychosis and borderline personality disorder. An in-depth assessment of personality functioning and self-disorders could be helpful in differentiating diagnoses, treatment planning, and establishing foci for psychotherapeutic treatment modalities.
Disclosure of InterestM. Gruber: None Declared, J. Alexopoulos: None Declared, K. Feichtinger: None Declared, K. Parth: None Declared, A. Wininger: None Declared, N. Mossaheb: None Declared, F. Friedrich: None Declared, Z. Litvan: None Declared, B. Hinterbuchinger: None Declared, S. Doering: None Declared, V. Blüml Grant / Research support from: Grant / Research support from: Heigl-Foundation, Köhler-Foundation, International Psychoanalytical Association (IPA)
FC25-02 - Functional MRI activation in response to panic-specific, non-panic aversive, and neutral imagery in patients with panic disorder and healthy controls
- D. Wedekind, O. Gruber, K. Obst, P. Dechent, K.R. Engel, K. Ulrich, B. Bandelow
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- Journal:
- European Psychiatry / Volume 26 / Issue S2 / March 2011
- Published online by Cambridge University Press:
- 16 April 2020, p. 1954
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Introduction
There is evidence that, besides limbic brain structures, prefrontal and insular cortical activations and deactivations are involved in the pathophysiology of panic disorder.
Objectives and aimsUsing fMRI, this study investigated BOLD response patterns to stimulation with individually selected panic-specific pictures in patients with panic disorder with agoraphobia (PDA) and healthy controls. Structures of interest were the prefrontal, cingulate, and insular cortex, and the amygdalo-hippocampal complex.
Methods21 PDA subjects (12 female, 9 male) and 21 matched controls were investigated using a Siemens 3 T scanner. Before, PDA subjects gave ratings on 120 pictures showing characteristic panic/agoraphobia situations (PA). 20 pictures with the individually highest ratings were selected. 20 matching pictures showing aversive but not panic-specific stimuli (A) and 80 neutral pictures (N) from the International Affective Picture-System (IAPS) were chosen for each subject. Anxiety and depression ratings were recorded.
ResultsGroup comparisons revealed a significantly greater BOLD response in PDA subjects than in controls in the insular cortices, left inferior frontal gyrus, dmPFC, the left hippocampal formation, and left caudatum (p < .005), when PA and N responses were compared. Group comparisons for stimulation with A compared to PA showed activation of similar brain regions in both groups but with different peak coordinates.
ConclusionsResults indicate specific activation patterns to panic-specific picture stimulation in PDA patients. Distinct peak coordinates between PA and A differ between groups. This might implicate that the brain circuits underlying processing of aversive stimuli might differ in their function in PDA patients compared to healthy subjects.
Abbreviated dignity therapy for adults with advanced-stage cancer and their family caregivers: Qualitative analysis of a pilot study
- Adrienne Beck, Ann H. Cottingham, Patrick V. Stutz, Rachel Gruber, Jennifer K. Bernat, Paul R. Helft, Laura Wilhelm, Karen Schmidt, Madison E. Stout, Claire Willard, Shelley A. Johns
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- Journal:
- Palliative & Supportive Care / Volume 17 / Issue 3 / June 2019
- Published online by Cambridge University Press:
- 24 July 2018, pp. 262-268
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Objective
Dignity therapy (DT) is designed to address psychological and existential challenges that terminally ill individuals face. DT guides patients in developing a written legacy project in which they record and share important memories and messages with those they will leave behind. DT has been demonstrated to ease existential concerns for adults with advanced-stage cancer; however, lack of institutional resources limits wide implementation of DT in clinical practice. This study explores qualitative outcomes of an abbreviated, less resource-intensive version of DT among participants with advanced-stage cancer and their legacy project recipients.
MethodQualitative methods were used to analyze postintervention interviews with 11 participants and their legacy recipients as well as the created legacy projects. Direct content analysis was used to assess feedback from the interviews about benefits, barriers, and recommendations regarding abbreviated DT. The legacy projects were coded for expression of core values.
ResultFindings suggest that abbreviated DT effectively promotes (1) self-expression, (2) connection with loved ones, (3) sense of purpose, and (4) continuity of self. Participants observed that leading the development of their legacy projects promoted independent reflection, autonomy, and opportunities for family interaction when reviewing and discussing the projects. Consistent with traditional DT, participants expressed “family” as the most common core value in their legacy projects. Expression of “autonomy” was also a notable finding.
Significance of resultsAbbreviated DT reduces resource barriers to conducting traditional DT while promoting similar benefits for participants and recipients, making it a promising adaptation warranting further research. The importance that patients place on family and autonomy should be honored as much as possible by those caring for adults with advanced-stage cancer.
You'll feel better in the morning: slow wave activity and overnight mood regulation in interepisode bipolar disorder
- A. M. Soehner, K. A. Kaplan, J. M. Saletin, L. S. Talbot, I. S. Hairston, J. Gruber, P. Eidelman, M. P. Walker, A. G. Harvey
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- Journal:
- Psychological Medicine / Volume 48 / Issue 2 / January 2018
- Published online by Cambridge University Press:
- 19 June 2017, pp. 249-260
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Background
Sleep disturbances are prominent correlates of acute mood episodes and inadequate recovery in bipolar disorder (BD), yet the mechanistic relationship between sleep physiology and mood remains poorly understood. Using a series of pre-sleep mood inductions and overnight sleep recording, this study examined the relationship between overnight mood regulation and a marker of sleep intensity (non-rapid eye movement sleep slow wave activity; NREM SWA) during the interepisode phase of BD.
MethodsAdults with interepisode BD type 1 (BD; n = 20) and healthy adult controls (CTL; n = 23) slept in the laboratory for a screening night, a neutral mood induction night (baseline), a happy mood induction night, and a sad mood induction night. NREM SWA (0.75–4.75 Hz) was derived from overnight sleep EEG recordings. Overnight mood regulation was evaluated using an affect grid pleasantness rating post-mood induction (pre-sleep) and the next morning.
ResultsOvernight mood regulation did not differ between groups following the sad or happy inductions. SWA did not significantly change for either group on the sad induction night compared with baseline. In BD only, SWA on the sad night was related to impaired overnight negative mood regulation. On the happy induction night, SWA increased relative to baseline in both groups, though SWA was not related to overnight mood regulation for either group.
ConclusionsThese findings indicate that SWA disruption may play a role in sustaining negative mood state from the previous night in interepisode BD. However, positive mood state could enhance SWA in bipolar patients and healthy adults.
Prefrontal cortical thinning links to negative symptoms in schizophrenia via the ENIGMA consortium
- E. Walton, D. P. Hibar, T. G. M. van Erp, S. G. Potkin, R. Roiz-Santiañez, B. Crespo-Facorro, P. Suarez-Pinilla, N. E. M. van Haren, S. M. C. de Zwarte, R. S. Kahn, W. Cahn, N. T. Doan, K. N. Jørgensen, T. P. Gurholt, I. Agartz, O. A. Andreassen, L. T. Westlye, I. Melle, A. O. Berg, L. Morch-Johnsen, A. Færden, L. Flyckt, H. Fatouros-Bergman, Karolinska Schizophrenia Project Consortium (KaSP), E. G. Jönsson, R. Hashimoto, H. Yamamori, M. Fukunaga, N. Jahanshad, P. De Rossi, F. Piras, N. Banaj, G. Spalletta, R. E. Gur, R. C. Gur, D. H. Wolf, T. D. Satterthwaite, L. M. Beard, I. E. Sommer, S. Koops, O. Gruber, A. Richter, B. Krämer, S. Kelly, G. Donohoe, C. McDonald, D. M. Cannon, A. Corvin, M. Gill, A. Di Giorgio, A. Bertolino, S. Lawrie, T. Nickson, H. C. Whalley, E. Neilson, V. D. Calhoun, P. M. Thompson, J. A. Turner, S. Ehrlich
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- Psychological Medicine / Volume 48 / Issue 1 / January 2018
- Published online by Cambridge University Press:
- 26 May 2017, pp. 82-94
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Background
Our understanding of the complex relationship between schizophrenia symptomatology and etiological factors can be improved by studying brain-based correlates of schizophrenia. Research showed that impairments in value processing and executive functioning, which have been associated with prefrontal brain areas [particularly the medial orbitofrontal cortex (MOFC)], are linked to negative symptoms. Here we tested the hypothesis that MOFC thickness is associated with negative symptom severity.
MethodsThis study included 1985 individuals with schizophrenia from 17 research groups around the world contributing to the ENIGMA Schizophrenia Working Group. Cortical thickness values were obtained from T1-weighted structural brain scans using FreeSurfer. A meta-analysis across sites was conducted over effect sizes from a model predicting cortical thickness by negative symptom score (harmonized Scale for the Assessment of Negative Symptoms or Positive and Negative Syndrome Scale scores).
ResultsMeta-analytical results showed that left, but not right, MOFC thickness was significantly associated with negative symptom severity (βstd = −0.075; p = 0.019) after accounting for age, gender, and site. This effect remained significant (p = 0.036) in a model including overall illness severity. Covarying for duration of illness, age of onset, antipsychotic medication or handedness weakened the association of negative symptoms with left MOFC thickness. As part of a secondary analysis including 10 other prefrontal regions further associations in the left lateral orbitofrontal gyrus and pars opercularis emerged.
ConclusionsUsing an unusually large cohort and a meta-analytical approach, our findings point towards a link between prefrontal thinning and negative symptom severity in schizophrenia. This finding provides further insight into the relationship between structural brain abnormalities and negative symptoms in schizophrenia.
Occupational differences in US Army suicide rates
- R. C. Kessler, M. B. Stein, P. D. Bliese, E. J. Bromet, W. T. Chiu, K. L. Cox, L. J. Colpe, C. S. Fullerton, S. E. Gilman, M. J. Gruber, S. G. Heeringa, L. Lewandowski-Romps, A. Millikan-Bell, J. A. Naifeh, M. K. Nock, M. V. Petukhova, A. J. Rosellini, N. A. Sampson, M. Schoenbaum, A. M. Zaslavsky, R. J. Ursano
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- Psychological Medicine / Volume 45 / Issue 15 / November 2015
- Published online by Cambridge University Press:
- 20 July 2015, pp. 3293-3304
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Background
Civilian suicide rates vary by occupation in ways related to occupational stress exposure. Comparable military research finds suicide rates elevated in combat arms occupations. However, no research has evaluated variation in this pattern by deployment history, the indicator of occupation stress widely considered responsible for the recent rise in the military suicide rate.
MethodThe joint associations of Army occupation and deployment history in predicting suicides were analysed in an administrative dataset for the 729 337 male enlisted Regular Army soldiers in the US Army between 2004 and 2009.
ResultsThere were 496 suicides over the study period (22.4/100 000 person-years). Only two occupational categories, both in combat arms, had significantly elevated suicide rates: infantrymen (37.2/100 000 person-years) and combat engineers (38.2/100 000 person-years). However, the suicide rates in these two categories were significantly lower when currently deployed (30.6/100 000 person-years) than never deployed or previously deployed (41.2–39.1/100 000 person-years), whereas the suicide rate of other soldiers was significantly higher when currently deployed and previously deployed (20.2–22.4/100 000 person-years) than never deployed (14.5/100 000 person-years), resulting in the adjusted suicide rate of infantrymen and combat engineers being most elevated when never deployed [odds ratio (OR) 2.9, 95% confidence interval (CI) 2.1–4.1], less so when previously deployed (OR 1.6, 95% CI 1.1–2.1), and not at all when currently deployed (OR 1.2, 95% CI 0.8–1.8). Adjustment for a differential ‘healthy warrior effect’ cannot explain this variation in the relative suicide rates of never-deployed infantrymen and combat engineers by deployment status.
ConclusionsEfforts are needed to elucidate the causal mechanisms underlying this interaction to guide preventive interventions for soldiers at high suicide risk.
Is it necessary to split nitrogen fertilization for winter wheat? On-farm research on Luvisols in South-West Germany – CORRIGENDUM
- R. SCHULZ, T. MAKARY, S. HUBERT, K. HARTUNG, S. GRUBER, S. DONATH, J. DÖHLER, K. WEIß, E. EHRHART, W. CLAUPEIN, H.-P. PIEPHO, C. PEKRUN, T. MÜLLER
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- Journal:
- The Journal of Agricultural Science / Volume 153 / Issue 7 / September 2015
- Published online by Cambridge University Press:
- 15 July 2015, p. 1149
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Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys
- R. C. Kessler, N. A. Sampson, P. Berglund, M. J. Gruber, A. Al-Hamzawi, L. Andrade, B. Bunting, K. Demyttenaere, S. Florescu, G. de Girolamo, O. Gureje, Y. He, C. Hu, Y. Huang, E. Karam, V. Kovess-Masfety, S Lee, D. Levinson, M. E. Medina Mora, J. Moskalewicz, Y. Nakamura, F. Navarro-Mateu, M. A. Oakley Browne, M. Piazza, J. Posada-Villa, T. Slade, M. ten Have, Y. Torres, G. Vilagut, M. Xavier, Z. Zarkov, V. Shahly, M. A. Wilcox
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 24 / Issue 3 / June 2015
- Published online by Cambridge University Press:
- 27 February 2015, pp. 210-226
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Background.
To examine cross-national patterns and correlates of lifetime and 12-month comorbid DSM-IV anxiety disorders among people with lifetime and 12-month DSM-IV major depressive disorder (MDD).
Method.Nationally or regionally representative epidemiological interviews were administered to 74 045 adults in 27 surveys across 24 countries in the WHO World Mental Health (WMH) Surveys. DSM-IV MDD, a wide range of comorbid DSM-IV anxiety disorders, and a number of correlates were assessed with the WHO Composite International Diagnostic Interview (CIDI).
Results.45.7% of respondents with lifetime MDD (32.0–46.5% inter-quartile range (IQR) across surveys) had one of more lifetime anxiety disorders. A slightly higher proportion of respondents with 12-month MDD had lifetime anxiety disorders (51.7%, 37.8–54.0% IQR) and only slightly lower proportions of respondents with 12-month MDD had 12-month anxiety disorders (41.6%, 29.9–47.2% IQR). Two-thirds (68%) of respondents with lifetime comorbid anxiety disorders and MDD reported an earlier age-of-onset (AOO) of their first anxiety disorder than their MDD, while 13.5% reported an earlier AOO of MDD and the remaining 18.5% reported the same AOO of both disorders. Women and previously married people had consistently elevated rates of lifetime and 12-month MDD as well as comorbid anxiety disorders. Consistently higher proportions of respondents with 12-month anxious than non-anxious MDD reported severe role impairment (64.4 v. 46.0%; χ21 = 187.0, p < 0.001) and suicide ideation (19.5 v. 8.9%; χ21 = 71.6, p < 0.001). Significantly more respondents with 12-month anxious than non-anxious MDD received treatment for their depression in the 12 months before interview, but this difference was more pronounced in high-income countries (68.8 v. 45.4%; χ21 = 108.8, p < 0.001) than low/middle-income countries (30.3 v. 20.6%; χ21 = 11.7, p < 0.001).
Conclusions.Patterns and correlates of comorbid DSM-IV anxiety disorders among people with DSM-IV MDD are similar across WMH countries. The narrow IQR of the proportion of respondents with temporally prior AOO of anxiety disorders than comorbid MDD (69.6–74.7%) is especially noteworthy. However, the fact that these proportions are not higher among respondents with 12-month than lifetime comorbidity means that temporal priority between lifetime anxiety disorders and MDD is not related to MDD persistence among people with anxious MDD. This, in turn, raises complex questions about the relative importance of temporally primary anxiety disorders as risk markers v. causal risk factors for subsequent MDD onset and persistence, including the possibility that anxiety disorders might primarily be risk markers for MDD onset and causal risk factors for MDD persistence.
Hypersomnia subtypes, sleep and relapse in bipolar disorder
- K. A. Kaplan, E. L. McGlinchey, A. Soehner, A. Gershon, L. S. Talbot, P. Eidelman, J. Gruber, A. G. Harvey
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- Journal:
- Psychological Medicine / Volume 45 / Issue 8 / June 2015
- Published online by Cambridge University Press:
- 17 December 2014, pp. 1751-1763
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Background.
Though poorly defined, hypersomnia is associated with negative health outcomes and new-onset and recurrence of psychiatric illness. Lack of definition impedes generalizability across studies. The present research clarifies hypersomnia diagnoses in bipolar disorder by exploring possible subgroups and their relationship to prospective sleep data and relapse into mood episodes.
Method.A community sample of 159 adults (aged 18–70 years) with bipolar spectrum diagnoses, euthymic at study entry, was included. Self-report inventories and clinician-administered interviews determined features of hypersomnia. Participants completed sleep diaries and wore wrist actigraphs at home to obtain prospective sleep data. Approximately 7 months later, psychiatric status was reassessed. Factor analysis and latent profile analysis explored empirical groupings within hypersomnia diagnoses.
Results.Factor analyses confirmed two separate subtypes of hypersomnia (‘long sleep’ and ‘excessive sleepiness’) that were uncorrelated. Latent profile analyses suggested a four-class solution, with ‘long sleep’ and ‘excessive sleepiness’ again representing two separate classes. Prospective sleep data suggested that the sleep of ‘long sleepers’ is characterized by a long time in bed, not long sleep duration. Longitudinal assessment suggested that ‘excessive sleepiness’ at baseline predicted mania/hypomania relapse.
Conclusions.This study is the largest of hypersomnia to include objective sleep measurement, and refines our understanding of classification, characterization and associated morbidity. Hypersomnia appears to be comprised of two separate subgroups: long sleep and excessive sleepiness. Long sleep is characterized primarily by long bedrest duration. Excessive sleepiness is not associated with longer sleep or bedrest, but predicts relapse to mania/hypomania. Understanding these entities has important research and treatment implications.
Understanding the elevated suicide risk of female soldiers during deployments
- A. E. Street, S. E. Gilman, A. J. Rosellini, M. B. Stein, E. J. Bromet, K. L. Cox, L. J. Colpe, C. S. Fullerton, M. J. Gruber, S. G. Heeringa, L. Lewandowski-Romps, R. J. A. Little, J. A. Naifeh, M. K. Nock, N. A. Sampson, M. Schoenbaum, R. J. Ursano, A. M. Zaslavsky, R. C. Kessler
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- Journal:
- Psychological Medicine / Volume 45 / Issue 4 / March 2015
- Published online by Cambridge University Press:
- 31 October 2014, pp. 717-726
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Background
The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) has found that the proportional elevation in the US Army enlisted soldier suicide rate during deployment (compared with the never-deployed or previously deployed) is significantly higher among women than men, raising the possibility of gender differences in the adverse psychological effects of deployment.
MethodPerson-month survival models based on a consolidated administrative database for active duty enlisted Regular Army soldiers in 2004–2009 (n = 975 057) were used to characterize the gender × deployment interaction predicting suicide. Four explanatory hypotheses were explored involving the proportion of females in each soldier's occupation, the proportion of same-gender soldiers in each soldier's unit, whether the soldier reported sexual assault victimization in the previous 12 months, and the soldier's pre-deployment history of treated mental/behavioral disorders.
ResultsThe suicide rate of currently deployed women (14.0/100 000 person-years) was 3.1–3.5 times the rates of other (i.e. never-deployed/previously deployed) women. The suicide rate of currently deployed men (22.6/100 000 person-years) was 0.9–1.2 times the rates of other men. The adjusted (for time trends, sociodemographics, and Army career variables) female:male odds ratio comparing the suicide rates of currently deployed v. other women v. men was 2.8 (95% confidence interval 1.1–6.8), became 2.4 after excluding soldiers with Direct Combat Arms occupations, and remained elevated (in the range 1.9–2.8) after adjusting for the hypothesized explanatory variables.
ConclusionsThese results are valuable in excluding otherwise plausible hypotheses for the elevated suicide rate of deployed women and point to the importance of expanding future research on the psychological challenges of deployment for women.
The effects of co-morbidity in defining major depression subtypes associated with long-term course and severity
- K. J. Wardenaar, H. M. van Loo, T. Cai, M. Fava, M. J. Gruber, J. Li, P. de Jonge, A. A. Nierenberg, M. V. Petukhova, S. Rose, N. A. Sampson, R. A. Schoevers, M. A. Wilcox, J. Alonso, E. J. Bromet, B. Bunting, S. E. Florescu, A. Fukao, O. Gureje, C. Hu, Y. Q. Huang, A. N. Karam, D. Levinson, M. E. Medina Mora, J. Posada-Villa, K. M. Scott, N. I. Taib, M. C. Viana, M. Xavier, Z. Zarkov, R. C. Kessler
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- Journal:
- Psychological Medicine / Volume 44 / Issue 15 / November 2014
- Published online by Cambridge University Press:
- 17 July 2014, pp. 3289-3302
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Background.
Although variation in the long-term course of major depressive disorder (MDD) is not strongly predicted by existing symptom subtype distinctions, recent research suggests that prediction can be improved by using machine learning methods. However, it is not known whether these distinctions can be refined by added information about co-morbid conditions. The current report presents results on this question.
Method.Data came from 8261 respondents with lifetime DSM-IV MDD in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Outcomes included four retrospectively reported measures of persistence/severity of course (years in episode; years in chronic episodes; hospitalization for MDD; disability due to MDD). Machine learning methods (regression tree analysis; lasso, ridge and elastic net penalized regression) followed by k-means cluster analysis were used to augment previously detected subtypes with information about prior co-morbidity to predict these outcomes.
Results.Predicted values were strongly correlated across outcomes. Cluster analysis of predicted values found three clusters with consistently high, intermediate or low values. The high-risk cluster (32.4% of cases) accounted for 56.6–72.9% of high persistence, high chronicity, hospitalization and disability. This high-risk cluster had both higher sensitivity and likelihood ratio positive (LR+; relative proportions of cases in the high-risk cluster versus other clusters having the adverse outcomes) than in a parallel analysis that excluded measures of co-morbidity as predictors.
Conclusions.Although the results using the retrospective data reported here suggest that useful MDD subtyping distinctions can be made with machine learning and clustering across multiple indicators of illness persistence/severity, replication with prospective data is needed to confirm this preliminary conclusion.
Is it necessary to split nitrogen fertilization for winter wheat? On-farm research on Luvisols in South-West Germany
- R. SCHULZ, T. MAKARY, S. HUBERT, K. HARTUNG, S. GRUBER, S. DONATH, J. DÖHLER, K. WEIß, E. EHRHART, W. CLAUPEIN, H.-P. PIEPHO, C. PEKRUN, T. MÜLLER
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- Journal:
- The Journal of Agricultural Science / Volume 153 / Issue 4 / May 2015
- Published online by Cambridge University Press:
- 01 May 2014, pp. 575-587
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Mineral nitrogen (N) fertilization in cereals is commonly split into three or four applications. In order to simplify N fertilization, a single N application either broadcast or placed on the soil surface was compared to conventionally split fertilization for winter wheat (Triticum aestivum L.). The 4-year experiment (2007–2010) was performed using a participatory approach on farmers’ fields on deep loamy soils (Luvisols) in South-West Germany.
Grain yield and crude protein contents differed only slightly or not at all between treatments including different N fertilizer types (calcium ammonium nitrate, urea ammonium nitrate solution, urea) and application techniques (broadcast, placed). Furthermore, no differences were found for the yield components ears/m2 and thousand grain weight. Inorganic N in the soil profile after harvest was generally below 40 kg N/ha and did not differ between treatments. In the area where N was placed, mineral N was depleted during the vegetation period.
At the experimental sites a single N application in the period between tillering and stem elongation was sufficient to achieve high yield and quality of winter wheat without increased risk of nitrate leaching. This finding was independent of the method of application or the type of fertilizer.
Sociodemographic and career history predictors of suicide mortality in the United States Army 2004–2009
- S. E. Gilman, E. J. Bromet, K. L. Cox, L. J. Colpe, C. S. Fullerton, M. J. Gruber, S. G. Heeringa, L. Lewandowski-Romps, A. M. Millikan-Bell, J. A. Naifeh, M. K. Nock, M. V. Petukhova, N. A. Sampson, M. Schoenbaum, M. B. Stein, R. J. Ursano, S. Wessely, A. M. Zaslavsky, R. C. Kessler,
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- Journal:
- Psychological Medicine / Volume 44 / Issue 12 / September 2014
- Published online by Cambridge University Press:
- 19 February 2014, pp. 2579-2592
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Background
The US Army suicide rate has increased sharply in recent years. Identifying significant predictors of Army suicides in Army and Department of Defense (DoD) administrative records might help focus prevention efforts and guide intervention content. Previous studies of administrative data, although documenting significant predictors, were based on limited samples and models. A career history perspective is used here to develop more textured models.
MethodThe analysis was carried out as part of the Historical Administrative Data Study (HADS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). De-identified data were combined across numerous Army and DoD administrative data systems for all Regular Army soldiers on active duty in 2004–2009. Multivariate associations of sociodemographics and Army career variables with suicide were examined in subgroups defined by time in service, rank and deployment history.
ResultsSeveral novel results were found that could have intervention implications. The most notable of these were significantly elevated suicide rates (69.6–80.0 suicides per 100 000 person-years compared with 18.5 suicides per 100 000 person-years in the total Army) among enlisted soldiers deployed either during their first year of service or with less than expected (based on time in service) junior enlisted rank; a substantially greater rise in suicide among women than men during deployment; and a protective effect of marriage against suicide only during deployment.
ConclusionsA career history approach produces several actionable insights missed in less textured analyses of administrative data predictors. Expansion of analyses to a richer set of predictors might help refine understanding of intervention implications.
Contributors
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- By Robert S. Anderson, (Mary) Colleen Bhalla, Michelle Blanda, Christopher Carpenter, Chris Chauhan, Paul L. DeSandre, Maura Dickinson, Jonathan A. Edlow, Dany Elsayegh, Kara Iskyan Geren, Peter J. Gruber, Jin H. Han, Marianne Haughey, Teresita M. Hogan, Ula Hwang, Lindsay Jin, Michael P. Jones, Joseph H. Kahn, Keli M. Kwok, Denise Law, Megan M. Leo, Stephen Y. Liang, Judith A. Linden, Brendan G. Magauran Jr, Joseph P. Martinez, Amal Mattu, Karen M. May, Aileen McCabe, Kerry K. McCabe, Jolion McGreevy, Ron Medzon, Ravi K. Murthy, Aneesh T. Narang, Lauren M. Nentwich, David E. Newman-Toker, Jonathan S. Olshaker, Joseph R. Pare, Thomas Perera, Joanna Piechniczek-Buczek, Jesse M. Pines, Timothy Platts-Mills, Suzanne Michelle Rhodes, Lynne Rosenberg, Mark Rosenberg, Todd C. Rothenhaus, Kristine Samson, Arthur B. Sanders, Jeffrey I. Schneider, Rishi Sikka, Kirk A. Stiffler, Morsal R. Tahouni, Mary E. Tanski, Abel Wakai, Scott T. Wilber, Deborah R. Wong
- Edited by Joseph H. Kahn, Brendan G. Magauran, Jr, Jonathan S. Olshaker
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- Book:
- Geriatric Emergency Medicine
- Published online:
- 05 January 2014
- Print publication:
- 16 January 2014, pp vii-x
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A comparative analysis of role attainment and impairment in binge-eating disorder and bulimia nervosa: results from the WHO World Mental Health Surveys
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- R.C. Kessler, V. Shahly, J.I. Hudson, D. Supina, P.A. Berglund, W.T. Chiu, M. Gruber, S. Aguilar-Gaxiola, J. Alonso, L.H. Andrade, C. Benjet, R. Bruffaerts, G. de Girolamo, R. de Graaf, S.E. Florescu, J.M. Haro, S.D. Murphy, J. Posada-Villa, K. Scott, M. Xavier
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 23 / Issue 1 / March 2014
- Published online by Cambridge University Press:
- 19 September 2013, pp. 27-41
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Background.
Cross-national population data from the WHO World Mental Health surveys are used to compare role attainments and role impairments associated with binge-eating disorder (BED) and bulimia nervosa (BN).
Methods.Community surveys assessed 23 000 adults across 12 countries for BED, BN and ten other DSM-IV mental disorders using the WHO Composite International Diagnostic Interview. Age-of-onset was assessed retrospectively. Ten physical disorders were assessed using standard conditions checklists. Analyses examined reciprocal time-lagged associations of eating disorders (EDs) with education, associations of early-onset (i.e., prior to completing education) EDs with subsequent adult role attainments and cross-sectional associations of current EDs with days of role impairment.
Results.BED and BN predicted significantly increased education (females). Student status predicted increased risk of subsequent BED and BN (females). Early-onset BED predicted reduced odds of current (at time of interview) marriage (females) and reduced odds of current employment (males). Early-onset BN predicted increased odds of current work disability (females and males). Current BED and BN were both associated with significantly increased days of role impairment (females and males). Significant BED and BN effects on adult role attainments and impairments were explained by controls for comorbid disorders.
Conclusions.Effects of BED on role attainments and impairments are comparable with those of BN. The most plausible interpretation of the fact that these associations are explained by comorbid disorders is that causal effects of EDs are mediated through secondary disorders. Controlled treatment effectiveness studies are needed to trace out long-term effects of BED–BN on secondary disorders.
Contributors
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- By Núria Duran Adroher, Sergio Aguilar-Gaxiola, Jordi Alonso, Ali Obaid Al-Hamzawi, Laura Helena Andrade, Matthias C. Angermeyer, James Anthony, Corina Benjet, Guilherme Borges, Joshua Breslau, Evelyn J. Bromet, Ronny Bruffaerts, Brendan Bunting, Huibert Burger, José Miguel Caldas de Almeida, Graça Cardoso, Somnath Chatterji, Wai Tat Chiu, Giovanni de Girolamo, Ron de Graaf, Peter de Jonge, Koen Demyttenaere, John Fayyad, Alize J. Ferrari, Silvia Florescu, Anne M. Gadermann, Meyer Glantz, Jen Green, Michael J. Gruber, Oye Gureje, Josep Maria Haro, Yanling He, Steven G. Heeringa, Hristo Hinkov, Chiyi Hu, Yueqin Huang, Irving Hwang, Robert Jin, Elie G. Karam, Norito Kawakami, Ronald C. Kessler, Lola Kola, Viviane Kovess-Masféty, Michael C. Lane, Carmen Lara, William LeBlanc, Sing Lee, Jean-Pierre Lépine, Daphna Levinson, Zhaorui Liu, Gustavo Loera, Herbert Marschinger, Katie A. McLaughlin, Maria Elena Medina-Mora, Elizabeth Miller, Samuel D. Murphy, Aimee Nasser Karam, Matthew K. Nock, Mark A. Oakley Browne, Siobhan O’Neill, Johan Ormel, Beth-Ellen Pennell, Maria V. Petukhova, José Posada-Villa, Rajesh Sagar, Mohammad Salih Khalaf, Nancy A. Sampson, Kathleen Saunders, Michael Schoenbaum, Kate M. Scott, Soraya Seedat, Victoria Shahly, Dan J. Stein, Hisateru Tachimori, Nezar Ismet Taib, Adley Tsang, T. Bedirhan Üstün, Maria Carmen Viana, Gemma Vilagut, Michael R. Von Korff, J. Elisabeth Wells, Harvey A. Whiteford, David R. Williams, Ben Wu, Miguel Xavier, Alan M. Zaslavsky
- Edited by Jordi Alonso, Universitat Pompeu Fabra, Barcelona, Somnath Chatterji, World Health Organization, Geneva, Yanling He
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- Book:
- The Burdens of Mental Disorders
- Print publication:
- 09 May 2013, pp ix-xii
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Composite International Diagnostic Interview screening scales for DSM-IV anxiety and mood disorders
- R. C. Kessler, J. R. Calabrese, P. A. Farley, M. J. Gruber, M. A. Jewell, W. Katon, P. E. Keck, Jr., A. A. Nierenberg, N. A. Sampson, M. K. Shear, A. C. Shillington, M. B. Stein, M. E. Thase, H.-U. Wittchen
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- Journal:
- Psychological Medicine / Volume 43 / Issue 8 / August 2013
- Published online by Cambridge University Press:
- 18 October 2012, pp. 1625-1637
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Background
Lack of coordination between screening studies for common mental disorders in primary care and community epidemiological samples impedes progress in clinical epidemiology. Short screening scales based on the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI), the diagnostic interview used in community epidemiological surveys throughout the world, were developed to address this problem.
MethodExpert reviews and cognitive interviews generated CIDI screening scale (CIDI-SC) item pools for 30-day DSM-IV-TR major depressive episode (MDE), generalized anxiety disorder (GAD), panic disorder (PD) and bipolar disorder (BPD). These items were administered to 3058 unselected patients in 29 US primary care offices. Blinded SCID clinical reinterviews were administered to 206 of these patients, oversampling screened positives.
ResultsStepwise regression selected optimal screening items to predict clinical diagnoses. Excellent concordance [area under the receiver operating characteristic curve (AUC)] was found between continuous CIDI-SC and DSM-IV/SCID diagnoses of 30-day MDE (0.93), GAD (0.88), PD (0.90) and BPD (0.97), with only 9–38 questions needed to administer all scales. CIDI-SC versus SCID prevalence differences are insignificant at the optimal CIDI-SC diagnostic thresholds (χ21 = 0.0–2.9, p = 0.09–0.94). Individual-level diagnostic concordance at these thresholds is substantial (AUC 0.81–0.86, sensitivity 68.0–80.2%, specificity 90.1–98.8%). Likelihood ratio positive (LR+) exceeds 10 and LR− is 0.1 or less at informative thresholds for all diagnoses.
ConclusionsCIDI-SC operating characteristics are equivalent (MDE, GAD) or superior (PD, BPD) to those of the best alternative screening scales. CIDI-SC results can be compared directly to general population CIDI survey results or used to target and streamline second-stage CIDIs.
Direct numerical simulation of premixed flame boundary layer flashback in turbulent channel flow
- A. Gruber, J. H. Chen, D. Valiev, C. K. Law
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- Journal:
- Journal of Fluid Mechanics / Volume 709 / 25 October 2012
- Published online by Cambridge University Press:
- 29 August 2012, pp. 516-542
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Direct numerical simulations are performed to investigate the transient upstream propagation (flashback) of premixed hydrogen–air flames in the boundary layer of a fully developed turbulent channel flow. Results show that the well-known near-wall velocity fluctuations pattern found in turbulent boundary layers triggers wrinkling of the initially flat flame sheet as it starts propagating against the main flow direction, and that the structure of the characteristic streaks of the turbulent boundary layer ultimately has an important impact on the resulting flame shape and on its propagation mechanism. It is observed that the leading edges of the upstream-propagating premixed flame are always located in the near-wall region of the channel and assume the shape of several smooth, curved bulges propagating upstream side by side in the spanwise direction and convex towards the reactant side of the flame. These leading-edge flame bulges are separated by thin regions of spiky flame cusps pointing towards the product side at the trailing edges of the flame. Analysis of the instantaneous velocity fields clearly reveals the existence, on the reactant side of the flame sheet, of backflow pockets that extend well above the wall-quenching distance. There is a strong correspondence between each of the backflow pockets and a leading edge convex flame bulge. Likewise, high-speed streaks of fast flowing fluid are found to be always colocated with the spiky flame cusps pointing towards the product side of the flame. It is suggested that the origin of the formation of the backflow pockets, along with the subsequent mutual feedback mechanism, is due to the interaction of the approaching streaky turbulent flow pattern with the Darrieus–Landau hydrodynamic instability and pressure fluctuations triggered by the flame sheet. Moreover, the presence of the backflow pockets, coupled with the associated hydrodynamic instability and pressure–flow field interaction, greatly facilitate flame propagation in turbulent boundary layers and ultimately results in high flashback velocities that increase proportionately with pressure.
Cross-national differences in the prevalence and correlates of burden among older family caregivers in the World Health Organization World Mental Health (WMH) Surveys
- V. Shahly, S. Chatterji, M. J. Gruber, A. Al-Hamzawi, J. Alonso, L. H. Andrade, M. C. Angermeyer, R. Bruffaerts, B. Bunting, J. M. Caldas-de-Almeida, G. de Girolamo, P. de Jonge, S. Florescu, O. Gureje, J. M. Haro, H. R. Hinkov, C. Hu, E. G. Karam, J.-P. Lépine, D. Levinson, M. E. Medina-Mora, J. Posada-Villa, N. A. Sampson, J. K. Trivedi, M. C. Viana, R. C. Kessler
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- Journal:
- Psychological Medicine / Volume 43 / Issue 4 / April 2013
- Published online by Cambridge University Press:
- 09 August 2012, pp. 865-879
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Background
Current trends in population aging affect both recipients and providers of informal family caregiving, as the pool of family caregivers is shrinking while demand is increasing. Epidemiological research has not yet examined the implications of these trends for burdens experienced by aging family caregivers.
MethodCross-sectional community surveys in 20 countries asked 13 892 respondents aged 50+ years about the objective (time, financial) and subjective (distress, embarrassment) burdens they experience in providing care to first-degree relatives with 12 broadly defined serious physical and mental conditions. Differential burden was examined by country income category, kinship status and type of condition.
ResultsAmong the 26.9–42.5% respondents in high-, upper-middle-, and low-/lower-middle-income countries reporting serious relative health conditions, 35.7–42.5% reported burden. Of those, 25.2–29.0% spent time and 13.5–19.4% money, while 24.4–30.6% felt distress and 6.4–21.7% embarrassment. Mean caregiving hours per week in those giving any time were 16.6–23.6 (169.9–205.8 h/week per 100 people aged 50+ years). Burden in low-/lower-middle-income countries was 2- to 3-fold higher than in higher-income countries, with any financial burden averaging 14.3% of median family income in high-, 17.7% in upper-middle-, and 39.8% in low-/lower-middle-income countries. Higher burden was reported by women than men and for conditions of spouses and children than parents or siblings.
ConclusionsUncompensated family caregiving is an important societal asset that offsets rising formal healthcare costs. However, the substantial burdens experienced by aging caregivers across multiple family health conditions and geographic regions threaten the continued integrity of their caregiving capacity. Initiatives supporting older family caregivers are consequently needed, especially in low-/lower-middle-income countries.