Environmental enrichment eliminates the anxiety phenotypes in a triple transgenic mouse model of Alzheimer’s disease

Although the impacts of environmental enrichment (EE) in several genetic models of Alzheimer’s disease (AD) have been documented, the focus has remained predominantly on cognition. Few have investigated the expression of emotional phenotypes that mimic the notable affective features in AD. Here, we studied the interaction between EE and the coexpression of three genetic risk factors (mutations) for AD. In a longitudinal design, 3×Tg-AD mutants and wild type controls were compared at 6–7 months and subsequently at 12–13 months of age. Under standard housing, phenotypes of heightened anxiety levels were identified in the 3×Tg-AD mice in the elevated plus maze and open-field tests. Such trait differences between genotypes were substantially diminished under EE housing, which was attributable to the anxiolytic impact of EE on the mutant mice as much as the anxiogenic impact of EE on the wild type mice. In contrast, the phenotypes in learned fear were not significantly modified by EE in the tests of Pavlovian freezing and conditioned active avoidance conducted at either age. Rearing under EE thus has uncovered a novel distinction between innate and acquired expressions of fear response in the 3×Tg-AD mouse model that might be relevant to the mental health management of AD.     

Impact of Panel Gene Testing for Hereditary Breast and Ovarian Cancer on Patients

Recent advances in next generation sequencing have enabled panel gene testing, or simultaneous testing for mutations in multiple genes for a clinical condition. With more extensive and widespread genetic testing, there will be increased detection of genes with moderate penetrance without established clinical guidelines and of variants of uncertain significance (VUS), or genetic variants unknown to either be disease-causing or benign. This study surveyed 232 patients who underwent genetic counseling for hereditary breast and ovarian cancer to examine the impact of panel gene testing on psychological outcomes, patient understanding, and utilization of genetic information. The survey used standardized instruments including the Impact of Event Scale (IES), Multidimensional Impact of Cancer Risk Assessment (MICRA), Satisfaction with Decision Instrument (SWD), Ambiguity Tolerance Scale (AT-20), genetics knowledge, and utilization of genetic test results. Study results suggested that unaffected individuals with a family history of breast or ovarian cancer who received positive results were most significantly impacted by intrusive thoughts, avoidance, and distress. However, scores were also modestly elevated among unaffected patients with a family history of breast and ovarian cancer who received VUS, highlighting the impact of ambiguous results that are frequent among patients undergoing genetic testing with large panels of genes. Potential risk factors for increased genetic testing-specific distress in this study included younger age, black or African American race, Hispanic origin, lower education level, and lower genetic knowledge and highlight the need for developing strategies to provide effective counseling and education to these communities, particularly when genetic testing utilizes gene panels that more commonly return VUS. More detailed pre-test education and counseling may help patients appreciate the probability of various types of test results and how results would be used clinically, and allow them to make more informed decisions about the type of genetic testing to select.     

A family therapy perspective on mediation

Many times, family therapists are both the first to learn that a couple may separate and the last to see them in the same consultation room, still relating to each other and the same professional before the adversarial system takes over. Mediation offers a viable alternative to that system because clients are helped to speak directly and craft the decisions that will delineate their move toward separate lives. Mediation is defined and the divorce process demystified, and the similarities and differences between mediation and therapy are discussed. Brief examples and a longer case discussion are provided to illustrate the mediation process. A familiarity with this process will enable therapists to hold more informed discussions about mediation with their clients and invite them to consider a process that is congruent with many of the values of family therapy.     

The Starting Early Starting Smart Integrated Services Model: Improving Access to Behavioral Health Services in the Pediatric Health Care Setting for At-Risk Families with Young Children

We evaluated the Starting Early Starting Smart (SESS) national initiative to integrate behavioral health services (parenting, mental health, and drug treatment) into the pediatric health care setting for families with young children. Data are presented from five pediatric care (PC) sites, drawing from families at risk due to demographic and behavioral health factors, with infants less than 12 months of age (n = 612). Families were randomly assigned to either the SESS program or a standard care Comparison group. We utilized longitudinal analyses to estimate differences in utilization rates for parenting, mental health, and drug treatment over 6 follow-up time points (3, 6, 9, 12, 15 and 18 months). Our findings indicate that SESS caregiver participants were 4.6 times (p < 0.001; CI = 3.33–6.26) more likely to receive parenting services, 2.1 times (p < 0.001; CI = 1.48–2.86) more likely to receive outpatient mental health treatment, and 1.8 times (p = 0.025; CI = 1.08–3.14) more likely to receive drug treatment than Comparison group participants. Our results demonstrate the success of the SESS program in coordinating and improving access to behavioral health services for high-risk caregivers within the pediatric health care setting and highlight the importance of continuing to focus public health policy on the behavioral health care needs of families with young children.     

The temporal relationship between alcohol consumption and HIV-medication adherence: a multilevel model of direct and moderating effects

Previous studies documenting an association between alcohol use and HIV medication nonadherence, have been unable to distinguish between-persons characteristics from within-person characteristics representing the temporally linked effects of alcohol. Hierarchical Linear Modeling (HLM) explored within- and between-person predictors of adherence during the past 14 days, as well as factors that moderate the event-level effects of alcohol consumption among 272 HIV-positive men and women with alcohol problems. On days in which participants drank, they had almost 9 times higher odds of medication nonadherence, with each drink increasing the odds by 20%. The cognitive and alcohol factors had significant between-person effects on adherence. Individuals with strong and rigid beliefs about the importance of strict medication adherence were significantly more affected by each dose of alcohol, while individuals with more alcohol use and problems were less affected by each drink. Regimen complexity increased the effects of having 1 or more drinks. These results highlight the importance of promoting medication adherence among alcohol-using adults, especially among patients with complex regimens or with high confidence and positive attitudes toward HIV medication.     

Anxiety,depression, and health-related quality of life in aging people living with HIV compared to diabetes patients and patients with minor health conditions: a longitudinal study

HIV infection has evolved from a fatal to a treatable condition, leading to an increase in the rate of elderly People Living with HIV (PLWH). However, little is known about the psychosocial burden of elderly PLWH. Thus, the aim of this longitudinal multi-center cohort study was to investigate whether elderly PLWH experience more anxiety and depression and reduced health related quality of life (HRQOL) compared to elderly patients with other chronic conditions. PLWH were compared to diabetes patients (DM) and patients with minor health conditions (MHC), e.g. patients with hypertension or allergic conditions. All patients were over 50 years old. Anxiety and depression (HADS) as well as HRQOL (SF-36) were assessed at baseline and after 12 months. 218 PLWH, 249 DM and 254 MHC were included. At baseline, the study groups did not differ in anxiety, depression, and physical HRQOL. However, PLWH indicated lower mental HRQOL than DM and MHC patients (p = 0.001). We did not obtain any moderating effects showing a differential effect of patient characteristics on anxiety, depression, and HRQOL in the three patient groups. At follow-up, the level of anxiety, depression, and HRQOL did not change significantly. The prevalence of anxiety ranged between 27 and 35%, and that of depression between 17 and 28%. Thus, the results of our investigation tentatively suggest that the psychosocial adaptation to HIV among elderly PLWH resembles those of other chronic diseases. There may be some subtle impairments, though, as PLWH experienced lower mental HRQOL.     

The Proclamation of Charles H. Long in the Time of Black Lives Matter,Standing Rock,and COVID-19

Revisiting Charles H. Long's 1991 proclamation of a modern crisis of materiality, this essay examines Long's theorization of the fetish-commodity legacies, that recreated African persons into objects and commodities, as a means of understanding our present tripartite pandemic of systemic racism, environmental destruction, and COVID-19. Examining the period of, what Long elsewhere terms, the “second creation,” I interrogate what this crisis means for the study of religion and for our society today. Building on Long's conception of “soul stuff” and yet moving beyond notions of human exceptionalism, I argue that to move beyond fetish and colonial legacies and realize a “third creation” (or, in other words, a (re-)re-creation), both scholars and the public must craft a new materialism that honors the ontological reality and value of all existence.     

African Religion,Climate Change,and Knowledge Systems

This article argues that as humanity is now changing the composition of the atmosphere at a rate that is very exceptional on the geological time scale, resulting in global warming, humans must deal with climate change holistically, including the often overlooked religion factor. Human‐caused climate change has resulted primarily from changes in the amounts of greenhouse gases in the atmosphere, but also from changes in small particles (aerosols), as well as from changes in land use. In Africa, the entire relationship between humans and nature, including activities such as land use, has deep religious and spiritual underpinnings. In general, religion is central to many of the decisions people make about their own communities’ development. Hence, this contribution examines religion as a factor that can be tapped into to mitigate negative effects of climate change, discussing climate change and religion in the context of development practice. It argues that some of the difficulties encountered in development, including efforts to reverse global warming in Africa, directly speak to the relegation of African cosmovision and conversely of the need to adopt new epistemologies, concepts, and models that take religion into consideration.     

Emotion Regulation in At‐Risk Preschoolers: Longitudinal Associations and Influences of Maternal Histories of Risk

Emotion regulation is a key challenge of early childhood. The present study examined emotion regulation behaviour longitudinally from infancy to preschool. The continuity of emotion regulation was explored within the larger ecological context of maternal childhood histories of aggression and social withdrawal and maternal use of constructive and non‐constructive behaviours. Forty‐five mothers with childhood histories of aggression or social withdrawal from the Concordia Longitudinal Risk Project, a prospective, longitudinal, intergenerational study, participated with their preschool children. Infants' emotion regulation behaviour was observed during interactions with their mothers when they were 5½ months of age. Emotion regulation in these same children as preschoolers was coded during an interference task using the Preschooler Self‐Regulatory Scheme. Longitudinal findings demonstrated continuity in children's use of emotion regulation behaviours from infancy to preschool. Higher maternal childhood histories of risk, specifically social withdrawal, contributed to the prediction of preschoolers' increased attention‐seeking behaviours. Mothers' use of non‐constructive verbalizations predicted more maladaptive styles of emotion regulation in their preschoolers. The findings highlight the importance of helping children develop adaptive emotion regulation skills from a young age and have implications for the design of preventive intervention programmes to help parents foster children's emotion regulation abilities. Copyright © 2015 John Wiley & Sons, Ltd.