Elevated suicide rates at high altitude: sociodemographic and health issues may be to blame

Suicide rates are higher at high altitudes; some hypothesize that hypoxia is the cause. We examined 8,871 suicides recorded in 2006 in 15 states by the National Violent Death Reporting System, with the victim's home county altitude determined from the National Elevation Dataset through FIPS code matching. We grouped cases by altitude (low<1000m; middle=1000-1999m; high≥2000m). Of reported suicides, 5% were at high and 83% at low altitude, but unadjusted suicide rates per 100,000 population were higher at high (17.7) than at low (5.7) altitude. High and low altitude victims differed with respect to race, ethnicity, rural residence, intoxication, depressed mood preceding the suicide, firearm use and recent financial, job, legal, or interpersonal problems. Even after multivariate adjustment, there were significant differences in personal, mental health, and suicide characteristics among altitude groups. Compared to low altitude victims, high altitude victims had higher odds of having family or friends report of a depressed mood preceding the suicide (OR 1.78; 95%CI:1.46-2.17) and having a crisis within 2weeks before death (OR 2.00; 95%CI:1.63-1.46). Suicide victims at high and low altitudes differ significantly by multiple demographic, psychiatric, and suicide characteristics; these factors, rather than hypoxia or altitude itself, may explain increased suicide rates at high altitude.     

Theoretical and statistical derivation of a screener for the behavioral assessment of executive functions in children

The problem of valid measurement of psychological constructs remains an impediment to scientific progress, and the measurement of executive functions is not an exception. This study examined the statistical and theoretical derivation of a behavioral screener for the estimation of executive functions in children from the well-established Behavior Assessment System for Children (BASC). The original national standardization sample of the BASC-Teacher Rating Scales for children ages 6 through 11 was used (N = 2,165). Moderate-to-high internal consistency was obtained within each factor (.80-.89). A panel of experts was used for content validity examination. A confirmatory factor analysis model with 25 items loading on 4 latent factors (behavioral control, emotional control, attentional control, and problem solving) was developed, and its statistical properties were examined. The multidimensional model demonstrated adequate fit, and it was deemed invariant after configural, metric, and scalar measurement invariance tests across sex and age. Given its strong psychometric properties, with further tests of item validity, this instrument promises future clinical and research utility for the screening of executive functions in school-age children.     

Cardiac morbidity risk and depression and anxiety: a disorder, symptom and trait analysis among cardiac surgery patients

The aim of this study was to examine depression and anxiety disorders and their characteristic symptoms (anhedonia/low positive affect and anxious arousal, respectively), along with measures of state negative affect (NA) and Type D personality, in relation to cardiac surgery related morbidity. Patients awaiting elective coronary artery bypass graft surgery (n=158; 20.9% female; 11.4% concomitant valve surgery; age M=64.7, SD=10.6) underwent the structured MINI International Neuropsychiatric Interview to determine current affective disorders. Patients also completed the Mood and Anxiety Symptom Questionnaire and a measure of Type D personality traits. Postoperative cardiac morbidity was confirmed after surgery during the index hospitalization and included stroke,renal failure, ventilation>24 h, deep sternal wound infection, reoperation, arrhythmia and 30-day mortality at any location (n=59, 37.3% of total). After adjustment for age, recent myocardial infarction, heart failure, hypertension, urgency of surgery and time spent on cardiopulmonary bypass generalized anxiety disorder was associated with cardiac morbidity (odds ratio [OR]=3.26, 95% confidence interval [CI] 1.10-9.67, p=0.03). Adjusted analysis of personality traits revealed the NA component of Type D personality was associated with cardiac morbidity (OR=1.07, 95% CI 1.01-1.14, p=0.03). The Mood and Anxiety Symptom Questionnaire subscales were not associated with increased morbidity risk. Affective disorders, affective phenotypes, and personality traits were differentially associated with post-cardiac surgery morbidity outcomes independent of cardiac surgery morbidity risk factors. Concurrent investigation of depression and anxiety with respect to cardiac outcomes warrants further research.     

Feeling bad about screwing up: emotion regulation and action monitoring in the anterior cingulate cortex

This study examined neural features of emotional responses to errors. We specifically examined whether directed emotion regulation of negative emotion associated with error modulates action-monitoring functions of anterior cingulate cortex, including conflict monitoring, error processing, and error prevention. Seventeen healthy adults performed a continuous performance task during assessment by fMRI. In each block, participants were asked either to increase or decrease their negative emotional responses or to react naturally after error commission. Emotion regulation instructions were associated with modulation of rostral and dorsal anterior activity and of their effective connectivity following errors and conflict. Cingulate activity and connectivity predicted subsequent errors. These data may suggest that responses to errors are affected by emotion and that aspects of emotion and cognition are inextricably linked, even during a nominally cognitive task.     

Binge eating proneness emerges during puberty in female rats: a longitudinal study

Puberty is a critical risk period for binge eating and eating disorders characterized by binge eating. Previous research focused almost entirely on psychosocial risk factors during puberty to the relative exclusion of biological influences. The current study addressed this gap by examining the emergence of binge eating during puberty in a rat model. We predicted that there would be minimal differences in binge eating proneness during pre-early puberty, but significant differences would emerge during puberty. Two independent samples of female Sprague-Dawley rats (n = 30 and n = 36) were followed longitudinally across pre-early puberty, mid-late puberty, and adulthood. Binge eating proneness was defined using the binge eating resistant (BER)/binge eating prone (BEP) model of binge eating that identifies BER and BEP rats in adulthood. Across two samples of rats, binge eating proneness emerged during puberty. Mixed linear models showed little difference in palatable food intake between BER and BEP rats during pre-early puberty, but significant group differences emerged during mid-late puberty and adulthood. Group differences could not be accounted for by changes in nonpalatable food intake or body weight. Similar to patterns in humans, individual differences in binge eating emerge during puberty in female rats. These findings provide strong confirming evidence for the importance of biological risk factors in developmental trajectories of binge eating risk across adolescence.     

The therapeutic alliance in adolescent substance abuse treatment: a one-with-many analysis

Studies of the therapeutic alliance typically use a one-with-many (OWM) design in which each therapist (the one) treats multiple clients (the many). This study used Kenny, Kashy, and Cook's (2006) OWM method to examine the composition of the therapeutic alliance and to analyze the association between alliance and outcome in a sample of 398 adolescents treated for substance abuse by 14 therapists. Both the client and therapist alliance ratings yielded large relationship variances, with limited consensus among clients treated by the same therapist about the quality of the alliance. If a client reported an especially strong alliance with his or her therapist, the therapist was likely to also report an especially strong alliance with that client (dyadic reciprocity). The association between the components of the alliance and treatment outcome was complicated, with different levels of measurement and different components of the alliance (perceiver, partner, or relationship) derived from different informants (therapist or client) relating to different outcomes.     

Patterns of Emotional Reactivity and Regulation in Children with Anxiety Disorders

Emotion dysregulation is believed to be a key factor in anxiety disorders. However, the empirical basis for this view is limited, particularly in children and adolescents. This study aimed to examine whether anxious children display negative emotional hyper-reactivity and deficits in emotion regulation, using a new task that presents ambiguous situations with potentially threatening meanings. Forty-nine children diagnosed with either generalized anxiety disorder, social anxiety, or separation anxiety disorder, were compared with 42 non-anxious controls. Relative to controls, anxious children demonstrated (a) greater intensity and frequency of negative emotional responses, (b) deficits in using reappraisal in negative emotional situations and corresponding deficits in reappraisal self-efficacy, and (c) greater reliance on emotion regulation strategies that increase the risk of functional impairment, intense negative emotion, and low emotion regulation self-efficacy. Implications for the assessment and treatment of childhood anxiety are discussed.     

Who are the Owners of Firearms Used in Adolescent Suicides?

In this brief report, the source of firearms used in adolescent suicides was examined using data from the National Violent Injury Statistics System, the pilot to the CDC's National Violent Death Reporting System, a uniform reporting system for violent and firearm-related deaths. Data represent the 63 firearm suicides among youth (<18 yrs) that occurred in 2001 or 2002 in one of four states (CT, ME, UT, WI) or two metropolitan counties (San Francisco, CA; Allegheny County, PA). Four-fifths of the suicides took place in the decedents' homes, and--when the firearm owner was known--most of the firearms were owned by parents. Findings replicate results from previous research and highlight the importance of limiting youth access to firearms.     

Linearity of Personality–Performance Relationships: A large‐scale examination

This paper reviews theory and past research concerning nonlinear relationships between personality tests and job performance. We compare linear and nonlinear regression models for each of the 32 Occupational Personality Questionnaire (OPQ32i) scales using job performance as the criterion variable. We evaluate linear, quadratic, and cubic relationships between personality and job performance by calculating changes in R (ΔR) between the linear and nonlinear models. We use 3 decision rules of varying levels for ΔR and divide a large sample randomly into 2 samples to cross‐validate any nonlinear effects found. Few scales exhibited nonlinearity and the magnitude of the departures from linearity were small.