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A common assumption to maximise cognitive training outcomes is that training tasks should be adaptive, with difficulty adjusted to the individual’s performance. This has only been tested once in adults (von Bastian & Eschen, 2016). We aimed to examine children’s outcomes of working memory training using adaptive, self-select and stepwise approaches to setting the difficulty of training tasks compared to an active control condition.
Participants and Methods:
In a randomised controlled trial (ACTRN 12621000990820), children in Grades 2-5 (7 to 11 years) were allocated to one of four conditions: adaptive working memory training, self-select working memory training, stepwise working memory training, or active control. An experimental intervention embedded in Minecraft was developed for teachers to deliver in the classroom over two weeks (10 x 20-minute sessions). The working memory training comprised two training tasks with processing demands similar to daily activities: backward span with digits and following instructions with objects. The control condition comprised creative building tasks. As part of a larger protocol, children completed at baseline and immediately post-intervention working memory measures similar to the training activities (primary outcome): backward span digits and letters versions, following instructions objects and letters versions. Primary analyses were intention-to-treat. Secondary analyses included only children who completed 10 sessions.
Results:
Of 204 children recruited into the study, 203 were randomised, with 95% retention at post-intervention. 76% of children completed all 10 training sessions. Comparisons between each working memory training condition and the active control on working memory measures were non-significant (f2 = 0.00), with one exception. Children in the self-select condition on average performed 1-point better than the controls on the following instructions objects measure (p = .02, f2 = 0.03). A pattern emerged that the self-select condition performed better on most measures.
Conclusions:
We found little evidence that an adaptive approach to setting the difficulty of training tasks maximises training outcomes for children. Findings suggest that working memory outcomes following training are limited and are not modulated by the approach to setting the difficulty of training tasks. This is consistent with findings from von Bastian & Eschen (2016), who also observed that the self-select condition (and not the adaptive condition) showed a slightly larger change in working memory performance following training than the control. It is helpful for clinicians to be aware that adaptive working memory training programs might not be superior in improving children’s working memory, and the benefits of programs are limited.
The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) will be held in Washington DC, USA, from Saturday, 26 August, 2023 to Friday, 1 September, 2023, inclusive. The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery will be the largest and most comprehensive scientific meeting dedicated to paediatric and congenital cardiac care ever held. At the time of the writing of this manuscript, The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery has 5,037 registered attendees (and rising) from 117 countries, a truly diverse and international faculty of over 925 individuals from 89 countries, over 2,000 individual abstracts and poster presenters from 101 countries, and a Best Abstract Competition featuring 153 oral abstracts from 34 countries. For information about the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery, please visit the following website: [www.WCPCCS2023.org]. The purpose of this manuscript is to review the activities related to global health and advocacy that will occur at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery.
Acknowledging the need for urgent change, we wanted to take the opportunity to bring a common voice to the global community and issue the Washington DC WCPCCS Call to Action on Addressing the Global Burden of Pediatric and Congenital Heart Diseases. A copy of this Washington DC WCPCCS Call to Action is provided in the Appendix of this manuscript. This Washington DC WCPCCS Call to Action is an initiative aimed at increasing awareness of the global burden, promoting the development of sustainable care systems, and improving access to high quality and equitable healthcare for children with heart disease as well as adults with congenital heart disease worldwide.
We performed a preimplementation assessment of workflows, resources, needs, and antibiotic prescribing practices of trainees and practicing dentists to inform the development of an antibiotic-stewardship clinical decision-support tool (CDST) for dentists.
Methods:
We used a technology implementation framework to conduct the preimplementation assessment via surveys and focus groups of students, residents, and faculty members. Using Likert scales, the survey assessed baseline knowledge and confidence in dental providers’ antibiotic prescribing. The focus groups gathered information on existing workflows, resources, and needs for end users for our CDST.
Results:
Of 355 dental providers recruited to take the survey, 213 (60%) responded: 151 students, 27 residents, and 35 faculty. The average confidence in antibiotic prescribing decisions was 3.2 ± 1.0 on a scale of 1 to 5 (ie, moderate). Dental students were less confident about prescribing antibiotics than residents and faculty (P < .01). However, antibiotic prescribing knowledge was no different between dental students, residents, and faculty. The mean likelihood of prescribing an antibiotic when it was not needed was 2.7 ± 0.6 on a scale of 1 to 5 (unlikely to maybe) and was not meaningfully different across subgroups (P = .10). We had 10 participants across 3 focus groups: 7 students, 2 residents, and 1 faculty member. Four major themes emerged, which indicated that dentists: (1) make antibiotic prescribing decisions based on anecdotal experiences; (2) defer to physicians’ recommendations; (3) have limited access to evidence-based resources; and (4) want CDST for antibiotic prescribing.
Conclusions:
Dentists’ confidence in antibiotic prescribing increased by training level, but knowledge did not. Trainees and practicing dentists would benefit from a CDST to improve appropriateness of antibiotic prescribing.
Mental health problems often begin in early childhood. However, the associations of various individual and contextual risk factors with mental health in the preschool period are incompletely understood, particularly in low- to middle-income countries (LMICs) where multiple risk factors co-exist. To address this gap, we prospectively followed 981 children in a South African birth cohort, the Drakenstein Child Health Study, assessing pre-and postnatal exposures and risk factors. The predictive value of these factors for child mental health (assessed by the Child Behavior Checklist) was modeled using structural equation modeling. We identified two key pathways to greater externalizing behavior: (1) prenatal exposure to substances (alcohol and smoking) directly predicted increased externalizing behavior (β = 0.24, p < 0.001); this relationship was partially mediated by an aspect of infant temperament (negative emotionality; β = 0.05, p = 0.016); (2) lower socioeconomic status and associated maternal prenatal depression predicted more coercive parenting, which in turn predicted increased externalizing behavior (β = 0.18, p = 0.001). Findings in this high-risk LMIC cohort cohere with research from higher income contexts, and indicate the need to introduce integrated screening and intervention strategies for maternal prenatal substance use and depression, and promoting positive parenting across the preschool period.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
Aims
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Method
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Results
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
Conclusions
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
In recent years, a variety of efforts have been made in political science to enable, encourage, or require scholars to be more open and explicit about the bases of their empirical claims and, in turn, make those claims more readily evaluable by others. While qualitative scholars have long taken an interest in making their research open, reflexive, and systematic, the recent push for overarching transparency norms and requirements has provoked serious concern within qualitative research communities and raised fundamental questions about the meaning, value, costs, and intellectual relevance of transparency for qualitative inquiry. In this Perspectives Reflection, we crystallize the central findings of a three-year deliberative process—the Qualitative Transparency Deliberations (QTD)—involving hundreds of political scientists in a broad discussion of these issues. Following an overview of the process and the key insights that emerged, we present summaries of the QTD Working Groups’ final reports. Drawing on a series of public, online conversations that unfolded at www.qualtd.net, the reports unpack transparency’s promise, practicalities, risks, and limitations in relation to different qualitative methodologies, forms of evidence, and research contexts. Taken as a whole, these reports—the full versions of which can be found in the Supplementary Materials—offer practical guidance to scholars designing and implementing qualitative research, and to editors, reviewers, and funders seeking to develop criteria of evaluation that are appropriate—as understood by relevant research communities—to the forms of inquiry being assessed. We dedicate this Reflection to the memory of our coauthor and QTD working group leader Kendra Koivu.1
Lichens occupy diverse substrates across tremendous ranges of environmental variation. In boreal forests, lichen communities co-occur in ‘strata’ defined by terrestrial or arboreal substrates, but these strata may or may not be interchangeable as bioindicators. Do co-occurring lichen strata have similar community structures and environmental responses? Could one stratum serve as a proxy for the other? We assessed variation in species richness and community compositions between ground-layer versus epiphyte-layer lichen strata in boreal forests and peatlands of interior Alaska. Species richness was lower and more spatially structured in the ground layer than the epiphyte layer. Richness of strata was not correlated. The most compositionally unique ground-layer communities were species-poor but contained regionally rare species not common in other plots. Variation in community compositions (ordination scores) were not congruent between strata (Procrustes congruence < 0.16 on 0–1 scale); the largest departures from congruence occurred where ground layers were species-poor. The best predictors of ground-layer community compositions were hydrological and topographic, whereas epiphytes were most associated with macroclimate and tree abundances. We conclude that lichens on different substrates ‘move in different circles’: compositional gradients did not agree and the environmental gradients most important to each lichen stratum were not the same. The conditions which strongly influence one vegetation stratum may have little bearing upon another. As global changes modify habitats, an incremental change in environment may lead community trajectories to diverge among lichen strata.
Spinal muscular atrophy (SMA) is a devastating rare disease that affects individuals regardless of ethnicity, gender, and age. The first-approved disease-modifying therapy for SMA, nusinursen, was approved by Health Canada, as well as by American and European regulatory agencies following positive clinical trial outcomes. The trials were conducted in a narrow pediatric population defined by age, severity, and genotype. Broad approval of therapy necessitates close follow-up of potential rare adverse events and effectiveness in the larger real-world population.
Methods:
The Canadian Neuromuscular Disease Registry (CNDR) undertook an iterative multi-stakeholder process to expand the existing SMA dataset to capture items relevant to patient outcomes in a post-marketing environment. The CNDR SMA expanded registry is a longitudinal, prospective, observational study of patients with SMA in Canada designed to evaluate the safety and effectiveness of novel therapies and provide practical information unattainable in trials.
Results:
The consensus expanded dataset includes items that address therapy effectiveness and safety and is collected in a multicenter, prospective, observational study, including SMA patients regardless of therapeutic status. The expanded dataset is aligned with global datasets to facilitate collaboration. Additionally, consensus dataset development aimed to standardize appropriate outcome measures across the network and broader Canadian community. Prospective outcome studies, data use, and analyses are independent of the funding partner.
Conclusion:
Prospective outcome data collected will provide results on safety and effectiveness in a post-therapy approval era. These data are essential to inform improvements in care and access to therapy for all SMA patients.
To investigate the association of prenatal alcohol exposure (PAE) and early neurodevelopment in the first 2 years of life, adjusting for maternal socio-demographic and psychosocial factors, in the Drakenstein Child Health Study (DCHS), a South African birth cohort study.
Methods:
The DCHS comprises a population-based birth cohort of 1143 children, of which a subsample completed the Bayley Scales of Infant Development-III (BSID-III) at 6 (n = 260) and 24 months of age (n = 734). A subset of alcohol-exposed and -unexposed children was included in this analysis at age 6 (n = 52 exposed; n = 104 unexposed) and 24 months (n = 92 exposed; n = 184 unexposed). Multiple hierarchical regression was used to explore the associations of PAE with motor and language development.
Results:
PAE was significantly associated with decreased gross motor [odds ratio (OR) = 0.16, 95% confidence interval (CI) = 0.06–0.44, p = 0.001] or fine motor (OR = 0.16, 95% CI = 0.06–0.46, p = 0.001) functioning after adjusting for maternal socio-demographic and psychosocial factors at 6 months of age only. No significant effects were found in either receptive or expressive communication and cognitive outcomes at either time points.
Conclusion:
PAE has potentially important consequences for motor development in the first 2 years of life, a period during which the most rapid growth and maturation occur. These findings highlight the importance of identifying high-risk families in order to provide preventive interventions, particularly in antenatal clinics and early intervention services.
For over 120 years, the shell middens of western Scotland and the series of open-air sites on Oronsay have been the focus of debate in European Mesolithic studies. This paper challenges the significance of Oronsay in light of results from the geophysical survey and test-excavation of a new limpet and periwinkle shell midden dated to the late 5th or start of the 4th millennium cal bc at Port Lobh, Colonsay that offers fresh evidence to re-evaluate critically the role of Oronsay and coastal resources in island settlement models ahead of the Mesolithic–Neolithic transition. Test excavations recovered a marine molluscan assemblage dominated by limpet and periwinkle shells together with crab, sea urchin, a fishbone assemblage composed mainly of Gadidae, some identifiable bird and mammal bone, carbonised macroplant remains, and pumice as well as a bipolar lithic assemblage and coarse stone implements. Novel seasonality studies of saithe otolith thin-sections suggest wintertime tidal fishing practices. At least two activity events may be discerned, dating from the late 5th millennium cal bc. The midden could represent a small number of rapidly deposited assemblages or maybe the result of stocastic events within a more extended timeframe. We argue that alternative research questions are needed to advance long-standing debates about seasonal inter-island mobility versus island sedentism that look beyond Oronsay to better understand later Mesolithic occupation patterns and the formation and date of Oronsay middens. We propose alternative methodological strategies to aid identification of contemporaneous sites using geophysical techniques and lithic technological signatures.
Our ALMA observations of HCO+ and HCN show such redshifted absorption toward an isolated core, BHR 71. Both lines show a similar redshifted absorption profile. We also found emissions of complex organic molecules (COMs) around 345 GHz from a compact region centered on the continuum source, which is barely resolved with a beam of 0″27, corresponding to ∼50 AU.
Vitamin D is a unique nutrient. First, it acts as a pro-hormone and secondly, the requirement for vitamin D can be met by both endogenous synthesis from sunlight and by dietary sources. This complicates the determination of dietary requirements for vitamin D, which along with the definition of optimal vitamin D status, have been highly controversial and much debated over recent years. Adolescents are a population group at high risk of low vitamin D status, which is concerning given the important role of vitamin D, and calcium, in promoting normal bone mineralisation and attainment of peak bone mass during this rapid growth phase. Dietary vitamin D recommendations are important from a public health perspective in helping to avoid deficiency and optimise vitamin D status for health. However limited experimental data from winter-based dose–response randomised trials in adolescents has hindered the development of evidence-based dietary requirements for vitamin D in this population group. This review will highlight how specifically designed randomised trials and the approach adopted for estimating such requirements can lead to improved recommendations. Such data indicate that vitamin D intakes of between 10 and about 30 µg/d may be required to avoid deficiency and ensure adequacy in adolescents, considerably greater than the current recommendations of 10–15 µg/d. Finally this review will consider the implications of this on public health policy, in terms of future refinements of vitamin D requirement recommendations and prioritisation of public health strategies to help prevent vitamin D deficiency.
A late Holocene carbonate spring mound and associated wetland deposits at Cienega Amarilla, New Mexico, contain a 4000-yr record of geomorphic, paleoenvironmental, and hydroclimatic change on the southern Colorado Plateau. Forty-four 14C dates support a century-scale chronostratigraphic framework. Pollen, plant macrofossil, mollusk, ostracode, and soil analyses indicate rapid spring mound growth and wetland expansion beginning ~2300 cal yr BP, followed by a pronounced decline in groundwater discharge (GWD) between ~1500 and 1000 cal yr BP. The isotopic composition of Cienega Amarilla springwater suggests GWD is driven primarily by winter precipitation. Historical climate data indicate that El Niño and warm Pacific Decadal Oscillation (PDO) conditions foster wetter-than-average winters in the Cienega Amarilla area, whereas dry winters are associated with La Niña conditions regardless of PDO phase. The ~2300–1500 cal yr BP Cienega Amarilla pluvial appears to represent an interval of peak, late Holocene cool-season precipitation that implies unusually strong or persistent El Niño–like and warm PDO–like conditions in the Pacific. Other southwestern paleoenvironmental records corroborate atypically wet conditions during this interval, and pluvial conditions related to increased winter precipitation likely fostered significant prehistoric cultural changes throughout the region, including increased sedentism, population, and dependence on agriculture.
A thick alluvial sequence in central New Mexico contains the Scholle wet meadow deposit that traces upstream to a paleospring. The wet meadow sediments contain an abundant fauna of twenty-one species of freshwater and terrestrial mollusks and ten species of ostracodes. The mollusks and ostracodes are indicative of a local high alluvial water table with spring-supported perennial flow but without standing water. Pollen analysis documents shrub grassland vegetation with sedges, willow, and alder in a riparian community. Stable carbon isotopes from the wet meadow sediments have δ13C values ranging from − 22.8 to − 23.3‰, indicating that 80% of the organic carbon in the sediment is derived from C3 species. The wet meadow deposit is AMS dated 10,400 to 9700 14C yr BP, corresponding to 12,300 to 11,100 cal yr BP and overlapping in time with the Younger Dryas event (YD). The wet meadow became active about 500 yr after the beginning of the YD and persisted 400 yr after the YD ended. The Scholle wet meadow is the only record of perennial flow and high water table conditions in the Abo Arroyo drainage basin during the past 13 ka.
Analysis of a buried deposit in the Diamond Valley of southern California has revealed well-preserved pollen, wood, and diatom remains. Accelerator mass spectrometry dates of 41,200±2100 and 41,490±1380 14C yr B.P. place this deposit in marine isotope stage 3. Diatoms suggest a shallow lacustrine environment. Pollen data suggest that several plant communities were present near the site, with grassland, scrub, chaparral, forest, and riparian communities represented. Comparison with modern pollen suggests similarities with montane forests in the nearby San Bernardino and San Jacinto ranges, indicating vegetation lowering by at least 900 m elevation and temperatures 4°–5°C cooler than today. An increase in high-elevation conifer pollen documents climatic cooling near the profile top. Early-profile diatoms are typical of warm water with high alkalinity and conductivity, whereas later diatoms suggest a higher flow regime and input of cooler water into the system. We suggest that the sequence is part of the cooling phase of an interstadial Dansgaard–Oeschger cycle. Records of the middle Wisconsin period are rare in southern California, but the Diamond Valley site is similar to records from Tulare Lake in the San Joaquin Valley and the ODP Site 893A record from Santa Barbara Basin. It is probable that the Diamond Valley assemblage is a local expression of a vegetation type widespread in the ranges and basins of southwestern California during the middle Wisconsin.
Using a combination of pollen, non-pollen palynomorphs (NPPs) and charcoal particle stratigraphies from sediment cores from two sites, along with historical records, we reconstructed paleoenvironmental change in mid-coastal California. The San Antonio Creek section contains a discontinuous, Holocene-length record, while Mod Pond includes a continuous late Holocene record. Together the records allow for interpretation of most of the present interglacial. The longer record documents coastal sage scrub and chaparral dominated by woodland elements early in the Holocene to about 9000 yr ago, a potential decline in woodland communities with drying conditions during the middle Holocene to about 4800 yr ago, and an expansion of coastal sage scrub with grassland during the late Holocene. Evidence for climatic fluctuations during the last 1000 yr at Mod Pond is equivocal, suggesting that the Medieval Climate Anomaly–Little Ice Age had modest impact on the Mod Pond environment. However, evidence of significant environmental change associated with cultural transitions in the 18th–19th centuries is stark. Introduction of non-native plants, establishment of cattle and sheep grazing, missionization of the native population, changes in burning practices during the Spanish period and enhanced cropping activities during North American settlement worked together to substantially modify the mid-California coastal landscape in about a century's time.
A 7.86-m sediment core from Swamp Lake in Yosemite National Park, California, provides a continuous record of environmental change over the last ca. 16,000 yr, as inferred from pollen, macrofossil, and microscopic charcoal analyses. The core stratigraphy documents late Wisconsin (Tioga stage) deglaciation between >16,000 and 13,700 yr B.P., approximately 6000-3500 yr earlier than higher-elevation Sierra Nevada records. The core includes five volcanic ash layers, chemically identified as four Mono Craters ashes and the Tsoyawata ash (Mt. Mazama, Oregon). The fossil record shows that herbs and sagebrush dominated the glacial environment at Swamp Lake. By 12,000 yr B.P., a mixed conifer forest composed of high- and mid-elevation conifers grew around the lake, suggesting a cool, wet late-glacial environment. The modern Sierra montane forest did not become established until ca. 10,400 yr B.P., when maximum charcoal concentrations and minimum fir pollen percentages indicate an early Holocene xeric period. The record suggests that a cooling trend began ca. 6500 yr B.P. and persisted until ca. 3700 yr B.P. when the modern climatic regime was established.
Fontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients.
Methods and results
This study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance. Medical history and biomarker values were obtained by chart review. Spearman’s Rank correlation assessed associations between biomarker z-scores and cardiac index. Biomarkers with significant correlations had receiver operating characteristic curves and area under the curve estimated. In total, 97 cardiac magnetic resonances in 87 patients met inclusion criteria: median age at cardiac magnetic resonance was 15 (6–33) years. Significant correlations were found between cardiac index and total alkaline phosphatase (−0.26, p=0.04), estimated creatinine clearance (0.26, p=0.02), and mean corpuscular volume (−0.32, p<0.01). Area under the curve for the three individual biomarkers was 0.63–0.69. Area under the curve for the three-biomarker panel was 0.75. Comparison of cardiac index above and below the receiver operating characteristic curve-identified cut-off points revealed significant differences for each biomarker (p<0.01) and for the composite panel [median cardiac index for higher-risk group=2.17 L/minute/m2 versus lower-risk group=2.96 L/minute/m2, (p<0.01)].
Conclusions
Higher total alkaline phosphatase and mean corpuscular volume as well as lower estimated creatinine clearance identify Fontan patients with lower cardiac index. Using biomarkers to monitor haemodynamics and organ-specific effects warrants prospective investigation.
Recent archaeological investigations at Pueblo Bonito in Chaco Canyon reveal that residents constructed a large diversion channel during the eleventh century A.D. as dramatic growth resulted in the expansion of the building onto the main valley floor. Sediments in the diversion channel reflect repeated episodes of flooding, rather than slow moving water typically found in irrigation canals, and archaeobotanical data indicate deposition during late summer or early fall. Although an agricultural function is possible, the channel may have been built primarily to divert floodwaters away from Pueblo Bonito while providing a nearby water source for construction and domestic use. The diversion channel was destroyed by the entrenchment of the “Bonito paleo-channel” in the late A.D. 1000s, and then buried by a combination of cultural debris and valley flooding. Although the canyon stream system changed throughout the occupation of Pueblo Bonito, there is no evidence that the formation of a deep natural channel in the floodplain had any negative effect on the growth of the great house
We previously reported an association between 5HTTLPR genotype and
outcome following cognitive–behavioural therapy (CBT) in child anxiety
(Cohort 1). Children homozygous for the low-expression short-allele
showed more positive outcomes. Other similar studies have produced mixed
results, with most reporting no association between genotype and CBT
outcome.
Aims
To replicate the association between 5HTTLPR and CBT outcome in child
anxiety from the Genes for Treatment study (GxT Cohort 2,
n = 829).
Method
Logistic and linear mixed effects models were used to examine the
relationship between 5HTTLPR and CBT outcomes. Mega-analyses using both
cohorts were performed.
Results
There was no significant effect of 5HTTLPR on CBT outcomes in Cohort 2.
Mega-analyses identified a significant association between 5HTTLPR and
remission from all anxiety disorders at follow-up (odds ratio 0.45,
P = 0.014), but not primary anxiety disorder
outcomes.
Conclusions
The association between 5HTTLPR genotype and CBT outcome did not
replicate. Short-allele homozygotes showed more positive treatment
outcomes, but with small, non-significant effects. Future studies would
benefit from utilising whole genome approaches and large, homogenous
samples.