Behavioral Health Services Influence Medical Treatment Utilization Among Primary Care Patients with Comorbid Substance Use and Depression

Although research has shown benefits of integrating psychological care in primary care settings, it is unclear how this form of treatment impacts individuals with comorbid substance use and depression. The findings are also mixed concerning how frequently this comorbid population seeks primary care services. This study examined the associations between substance use, depression, and medical treatment utilization among 224 primary care patients. The aim of the investigation was twofold. First, to determine if depression increases medical treatment utilization among patients with substance use disorders; second, to evaluate if behavioral health treatment reduces medical service utilization. A moderated mediation model with bootstrapping analyses revealed that depression strengthened the relationship between substance use and primary care treatment utilization (both medical and behavioral health). The model also indicated that behavioral health services were associated with fewer primary care visits for individuals with comorbid substance use and depression. Clinical and social implications are discussed.     

Anticipation of subsequent demanding exercise increases the expression of haem oxygenase-1 mRNA in human lymphocytes

Oxidative stress induces the expression of the cytoprotective and anti-inflammatory protein haem oxygenase-1 (HO-1). In the present investigation, we show that anticipation of subsequent exercise elevates the expression of HO-1 mRNA in lymphocytes. A between-groups comparison of HO-1 mRNA expression in subjects about to complete a half marathon race vs. subjects who were asked to sit quietly in the laboratory showed an elevated expression of HO-1 mRNA prior to exercise (2.6-fold higher in subjects prior to the half marathon, P < 0.01). This observation led us to examine whether anticipation of subsequent exercise leads to differences in lymphocyte HO-1 mRNA expression within the same subjects. In a second experiment, the same individuals completed two trials, one exercise and one rest, approximately 2 weeks apart in a randomised cross-over design. Lymphocyte HO-1 mRNA expression was greater prior to exercise (1.4 +/- 0.3-fold higher in the exercise trial, P < 0.05). These results suggest that knowledge of subsequent demanding exercise may lead to an anticipatory induction of HO-1 mRNA. We tentatively propose that this process has evolved to prepare lymphocytes for subsequent exercise-induced oxidative stress although the mechanism remains to be elucidated.     

Misremembering emotion: Inductive category effects for complex emotional stimuli

Memories of objects are biased toward what is typical of the category to which they belong. Prior research on memory for emotional facial expressions has demonstrated a bias towards an emotional expression prototype (e.g., slightly happy faces are remembered as happier). We investigate an alternate source of bias in memory for emotional expressions – the central tendency bias. The central tendency bias skews reconstruction of a memory trace towards the center of the distribution for a particular attribute. This bias has been attributed to a Bayesian combination of an imprecise memory for a particular object with prior information about its category. Until now, studies examining the central tendency bias have focused on simple stimuli. We extend this work to socially relevant, complex, emotional facial expressions. We morphed facial expressions on a continuum from sad to happy. Different ranges of emotion were used in four experiments in which participants viewed individual expressions and, after a variable delay, reproduced each face by adjusting a morph to match it. Estimates were biased toward the center of the presented stimulus range, and the bias increased at longer memory delays, consistent with the Bayesian prediction that as trace memory loses precision, category knowledge is given more weight. The central tendency effect persisted within and across emotion categories (sad, neutral, and happy). This article expands the scope of work on inductive category effects to memory for complex, emotional stimuli.     

Cognitive neuroscience of self-regulation failure

Self-regulatory failure is a core feature of many social and mental health problems. Self-regulation can be undermined by failures to transcend overwhelming temptations, negative moods and resource depletion, and when minor lapses in self-control snowball into self-regulatory collapse. Cognitive neuroscience research suggests that successful self-regulation is dependent on top-down control from the prefrontal cortex over subcortical regions involved in reward and emotion. We highlight recent neuroimaging research on self-regulatory failure, the findings of which support a balance model of self-regulation whereby self-regulatory failure occurs whenever the balance is tipped in favor of subcortical areas, either due to particularly strong impulses or when prefrontal function itself is impaired. Such a model is consistent with recent findings in the cognitive neuroscience of addictive behavior, emotion regulation and decision-making.     

Cognitive psychology meets psychometric theory: on the relation between process models for decision making and latent variable models for individual differences

This article analyzes latent variable models from a cognitive psychology perspective. We start by discussing work by Tuerlinckx and De Boeck (2005), who proved that a diffusion model for 2-choice response processes entails a 2-parameter logistic item response theory (IRT) model for individual differences in the response data. Following this line of reasoning, we discuss the appropriateness of IRT for measuring abilities and bipolar traits, such as pro versus contra attitudes. Surprisingly, if a diffusion model underlies the response processes, IRT models are appropriate for bipolar traits but not for ability tests. A reconsideration of the concept of ability that is appropriate for such situations leads to a new item response model for accuracy and speed based on the idea that ability has a natural zero point. The model implies fundamentally new ways to think about guessing, response speed, and person fit in IRT. We discuss the relation between this model and existing models as well as implications for psychology and psychometrics.     

Quasi-miracles,typicality, and counterfactuals

If one flips an unbiased coin a million times, there are 2^1,000,000 series of possible heads/tails sequences, any one of which might be the sequence that obtains, and each of which is equally likely to obtain. So it seems (1) ‘If I had tossed a fair coin one million times, it might have landed heads every time’ is true. But as several authors have pointed out, (2) ‘If I had tossed a fair coin a million times, it wouldn’t have come up heads every time’ will be counted as true in everyday contexts. And according to David Lewis’ influential semantics for counterfactuals, (1) and (2) are contradictories. We have a puzzle. We must either (A) deny that (2) is true, (B) deny that (1) is true, or (C) deny that (1) and (2) are contradictories, thus rejecting Lewis’ semantics. In this paper I discuss and criticize the proposals of David Lewis and more recently J. Robert G. Williams which solve the puzzle by taking option (B). I argue that we should opt for either (A) or (C).     

Hope I Die before I Get Old: Mispredicting Happiness Across the Adult Lifespan

The tendency to overestimate the influence of circumstances on well-being has been demonstrated for a range of life events, but the perceived impact of aging on well-being has been largely overlooked. People seem to dread growing old, despite evidence that well-being improves with age. We compared the self-reported happiness of younger adults (mean age = 31) and older adults (mean age = 68) with their estimates of happiness at different ages. Self-reports confirmed increasing happiness with age, yet both younger and older participants believed that happiness declines. Both groups estimated declining happiness for the average person, but only older adults estimated this decline for themselves.     

DNA methylation of NR3c1 in infancy: Associations between maternal caregiving and infant sex

Caregivers play a critical role in scaffolding infant stress reactivity and regulation, but the mechanisms by which this scaffolding occurs is unclear. Animal models strongly suggest that epigenetic processes, such as DNA methylation, are sensitive to caregiving behaviors and, in turn, offspring stress reactivity. We examined the direct effects of caregiving behaviors on DNA methylation in infants and infant stress reactivity. Infants and mothers (N = 128) were assessed during a free play when infants were 5 months old. Maternal responsiveness and appropriate touch were coded. and infant buccal epithelial cells were sampled to assess for DNA methylation of the glucocorticoid receptor gene, NR3c1 exon 1F. Infant cortisol reactivity was assessed in response to the still-face paradigm. Greater levels of maternal responsiveness and appropriate touch were related to less DNA methylation of specific regions in NR3c1 exon 1F, but only for females. There was no association with maternal responsiveness and appropriate touch or DNA methylation of NR3c1 exon 1F on prestress cortisol or cortisol reactivity. Our results are discussed in relation to programming models that implicate maternal care as an important factor in programing infant stress reactivity.     

A non‐normative account of assertion

Many contemporary philosophers argue that assertion is governed by an epistemic norm. In particular, many defend the knowledge account of assertion, which says that one should assert only what one knows. Here, I defend a non‐normative alternative to the knowledge account that I call the repK account of assertion. According to the repK account, assertion represents knowledge, but it is not governed by a constitutive epistemic rule. I show that the repK account offers a more straightforward interpretation of the conversational patterns and intuitions that motivate the knowledge account. It does so in terms of ordinary normative principles that philosophers already accept, none of which are constitutive to assertion. I then contend that the repK account is preferable to the knowledge account because it is simpler, its implications are less contentious, and it avoids a problem for normative accounts of assertion recently raised by Peter Pagin. I also argue that the repK account offers a satisfying explanation of selfless assertion, a counterexample to the knowledge account posed by Jennifer Lackey.     

The sandwich effect reassessed: Effects of streaming, distraction, and modality

The degree of disruption from interleaving auditory irrelevant items within a sequence of to-be-remembered items--the sandwich effect--was examined in two experiments. Previous demonstrations of the effect have shown that the penalty for interleaving items is small and that changing irrelevant tokens is no more damaging than repeating ones (contrary to the classic changing state effect of irrelevant sound). The results of Experiment 1 suggest that these earlier results were due to the lack of tokens in the irrelevant sequence (in part, the result of using a span method). The results of Experiment 2 also show that the sandwich effect was marked and, further, that it comprised two elements, one due to the partitioning of relevant from irrelevant streams (which may be promoted by similarity of identity within sequence or pitch disparity between sequences), and the other a classic irrelevant sound effect (with effects of changing state). The results are discussed in terms of the role of perceptual organization within and between modalities in short-term memory.