Optimizing Contingency Management With Methamphetamine-Using Men Who Have Sex With Men

Among men who have sex with men (MSM), methamphetamine use is associated with multiple, overlapping syndemic conditions including increased risk for HIV seroconversion and onward HIV transmission. Contingency management (CM) is an evidence-based behavioral intervention implemented to curb methamphetamine use and optimize HIV/AIDS prevention among MSM in San Francisco since 2003. We conducted a program evaluation to document the evolution of this 12-week CM program to include delivery of brief, individual counseling incorporating motivational interviewing and behavioral skills. A drop-in group delivered concurrently with CM urine-screening visits also provides peer support as well as referrals for other social and medical services. From December 2011–October 2013, a total of 131 clients enrolled in the CM program and provided a median of 22 urine samples (Interquartile Range = 10–34) that were nonreactive for methamphetamine. Findings support the feasibility and acceptability of integrating individual and group counseling with community-based CM for methamphetamine-using MSM.     

Acceptability of,and Information Needs Regarding,Next-Generation Sequencing in People Tested for Hereditary Cancer: A Qualitative Study

Next generation sequencing (NGS) for patients at risk of hereditary cancer syndromes can also identify non-cancer related mutations, as well as variants of unknown significance. This study aimed to determine what benefits and shortcomings patients perceive in relation to NGS, as well as their interest and information preferences in regards to such testing. Eligible patients had previously received inconclusive results from clinical mutation testing for cancer susceptibility. Semi-structured telephone interviews were subjected to qualitative analysis guided by the approach developed by Miles and Huberman. The majority of the 19 participants reported they would be interested in panel/genomic testing. Advantages identified included that it would enable better preparation and allow implementation of individualized preventative strategies, with few disadvantages mentioned. Almost all participants said they would want all results, not just those related to their previous diagnosis. Participants felt that a face-to-face discussion supplemented by an information booklet would be the best way to convey information and achieve informed consent. All participants wanted their information stored and reviewed in accordance with new developments. Although the findings indicate strong interest among these individuals, it seems that the consent process, and the interpretation and communication of results will be areas that will require revision to meet the needs of patients.     

Psychological,endocrine, and neural correlates of attentional bias in subclinical depression

Background: Our knowledge with respect to psychological, endocrine, and neural correlates of attentional bias in individuals with high vulnerability to developing depression – the subclinically depressed, still remains limited. Design: The study used a 2?×?2 mixed design. Methods: Attentional bias toward happy and sad faces in healthy (N?=?26) and subclinically depressed individuals (N?=?22) was assessed via a neuroimaging dot-probe attention task. Participants also completed trait and state psychological measures and provided saliva samples for cortisol analysis. Results: The subclinical group showed attentional bias toward happy faces; past use of problem-focused coping strategies when dealing with a personally relevant stressor as well as state levels of anxiety, together, contributed to this bias. In the control group, the happy attentional bias was positively correlated with activity in the right caudate. In the subclinical group, the bias was negatively associated with the left fusiform gyrus and positively with the left inferior parietal lobule and bilateral putamen. We observed group differences in association between cortisol levels during the task and neural activity during happy attentional bias processing within the key regions involved in attention. Conclusions: The attentional bias toward happy faces may reflect an active coping attempt by the subclinical participants.     

Preschool Executive Control and Internalizing Symptoms in Elementary School

Depression and anxiety are prevalent and impairing forms of psychopathology in children and adolescents. Deficits in early executive control (EC) may contribute to the development of these problems, but longitudinal studies with rigorous measurement across key developmental periods are limited. The current study examines EC in preschool as a predictor of subsequent depression and anxiety symptoms in elementary school in a community sample (N?=?280). Child participants completed a battery of nine developmentally-appropriate tasks designed to measure major aspects of EC at age 5 years, 3 months. Children later participated in an elementary school follow-up phase, during which they completed validated norm-referenced self-report questionnaires of depression and anxiety symptoms in fourth grade. Results indicate that poorer preschool EC was significantly associated with both greater depression and anxiety symptoms in elementary school, controlling for baseline depression and anxiety symptoms in preschool and other relevant variables. These findings suggest that poor EC may be an important risk factor for the development of internalizing psychopathology in childhood. Given emerging evidence for the modifiability of EC, particularly in preschool, EC promotion interventions may hold promise as a potential target in psychopathology prevention.     

Correspondence between MMPI PTSD measures and clinical diagnosis

Correspondence of the Minnesota Multiphasic Personality Inventory (MMPI) posttraumatic stress disorder (PTSD) subscale and the clinical scale decision rules reported by Keane, Malloy, and Fairbank (1984) with clinical diagnoses of PTSD was measured on a sample of 595 veterans. The measures demonstrated good sensitivity and selectivity, but the false-positive rate was high. It is suggested the MMPI measures be used to rule out, but not to establish, the diagnosis of PTSD. The construct validity of the PTSD subscale was supported by the finding of a higher mean score in combat than noncombat veterans.     

Constraints on nest site selection: a comparison of predator and flood avoidance in four species of marsh-nesting birds (genera: Catoptrophorus, Larus, Rallus, and Sterna)

Nest site characteristics associated with flood and predator avoidance were compared for four nonpasserine species of marsh-nesting birds: clapper rails, willets, laughing gulls, and common terns. Species with short nests, willets and terns, minimized flood damage by nesting on higher ground than did gulls and rails that build tall nests. Species with dispersed, cryptic nests had taller surrounding grass than did open-nesting colonial species. Total nest height was similar for species with tall nests and for terns whose short nests were elevated by placement on mats of dead Spartina grass. Willets had lower nest heights than the other species, probably because the inverse relation between grass height and ground height in the salt marsh makes it difficult for willets to find sites with high enough ground for flood avoidance while still retaining high enough grass for nest crypticity. Ground height for common terns and grass height for gulls and rails appear to be cues used in nest site selection. Nests of each species in which these characteristics were maximized were more successful in a major tidal flood. Laughing gulls and clapper rails appear to be more specialized salt marsh nesters than the other two species.     

Hyperventilation and anxiety in panic disorder, social phobia, GAD and normal controls

Patients with DSM-III Agoraphobia, Panic Disorder, GAD, Social Phobia and normal controls underwent a series of experimental procedures and measures to determine whether panic attack patients show a greater tendency towards hyperventilation that is independent from their anxiety levels. Contrary to expectations, the Agoraphobia and Panic Disorder patients did not show significantly lower levels of expired pCO2 at rest than the other anxious or non-anxious groups. However, the panic attack patients did show significantly higher levels of anxiety and hyperventilatory symptoms during a hyperventilation test and during breathing 5% CO2 in air. A strong relationship was found between hyperventilatory symptoms and anxiety in all groups of patients and in the controls. On the basis of these results it was concluded that Agoraphobia and Panic Disorder patients do not show a unique tendency toward hyperventilation, but rather that their hyperventilatory symptoms and perhaps intermittent overbreathing episodes are a function of the high levels of anxiety they experience.     

Dextrorphan effects on cocaine and brainstem perturbation

Dextrorphan is a noncompetitive blocker of N-methyl-D-aspartate (NMDA) receptors. Since NMDA blockers are known to reduce the locomotor stimulatory and toxic effects of cocaine, it was speculated that dextrorphan would attenuate cocaine-induced behavioral excitatory motor activity associated with and without mechanical perturbation of the brainstem. Technique: Motor activity was recorded following dextrorphan and/or cocaine challenge in 25 SHR rats. Ten were naive subjects. Mini-osmotic pumps delivering cocaine (2.5 mg/0.49 ul/hr) were placed in 15 subjects, and infusion was halted after the third infusion day. On the fifth day either a dextrorphan (25 mg/kg, subcutaneous) or a dextrorphan and cocaine (40 mg/kg, intraperitoneal) challenge was done. Ten rats had bipolar electrode implants in the bilateral brainstem. Five were treated with DC current lesions in each of 12 days over a 3-week period. The effects of brainstem lesions on escape behavior were also evaluated in those five subjects. Results: In the naive subjects, dextrorphan reduced motor activity (P=.0001), whereas combined cocaine and dextrorphan increased motor activity (P=0.04). In lesioned subjects, dextrorphan decreased motor activity (P=0.0001). In electrode implant subjects, combined dextrorphan and cocaine challenge decreased the motor activity (P=0.04). Hyperactivity in the electrode implant group was greater than in the lesioned subjects. Midbrain electrolytic lesions attenuated escape behavior. A variety of behaviors were produced by brainstem lesions. Conclusions: Dextrorphan and brainstem lesions reduced motor hyperactivity and escape behavior. In electrode implant subjects dextrorphan counteracted the expected cocaine excitatory motor effects. Dextrorphan did not activate nor facilitate seizures.