Post-traumatic stress symptoms of children and adolescents exposed to the 2008 Wenchuan Earthquake: A longitudinal study of 5-HTTLPR genotype main effects and gene–environment interactions

Experiencing disasters causes severe mental disorders, among which post-traumatic stress disorder (PTSD) is the most common. We conducted a longitudinal study to examine the effect of 5-hydroxyl tryptamine transporter gene-linked polymorphic region (5-HTTLPR) genotype on child and adolescent PTSD symptom course after the 2008 Wenchuan Earthquake. We genotyped 963 participants who personally experienced the earthquake. PTSD symptoms were measured by University of California, Los Angeles PTSD reaction index at 2.5, 3.5, 4.5 and 5.5 years after the earthquake, respectively. Latent growth model was utilised to examine the main effect and gene–environment interaction effect of 5-HTTLPR on PTSD's symptom course. 5-HTTLPR genotype predicted initial PTSD symptom severity (β = 0.108, p = .019) and rates of symptom recovery (β = −0.120, p = .031) between 2.5 and 5.5 years. Compared with L′ allele carriers, those with S′S′ genotype showed higher initial symptom severity but also faster recovery rate. 5-HTTLPR genotype only predicted symptom severity at 2.5 years after the earthquake, after controlling for sex, age, ethnicity and trauma severity (β = 0.108, p = .019). This is the first evidence of the effect of 5-HTTLPR genotype on child and adolescent PTSD symptoms longitudinally, offering a novel perspective on the effect of 5-HTTLPR on PTSD symptom development following trauma exposure.     

“If We’re Going to Change Things, It Has to Be Systemic:” Systems Change in Children’s Mental Health

Communities that undertake systems change in accordance with the system of care philosophy commit to creating new systems entities for children and adolescents with serious emotional disturbance. These new entities are values-based, voluntary, and cross-agency alliances that include formal child-serving entities, youth, and families. Describing the scope and intent of one such implementation of systems of care, a mental health administrator commented, "If we're going to change things, it has to be systemic" (B. Baxter, personal communication, December 2, 2005). This paper explores the concept of "systemic" in the context of systems of care. Systems theory is used to understand strategies of purposeful systems change undertaken by stakeholders in established system of care communities. The paper presents a conceptual model of systems change for systems of care that is grounded in data from a national study of system of care implementation (Research and Training Center for Children's Mental Health in Case Studies of system implementation: Holistic approaches to studying community-based systems of care: Study 2, University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children's Mental Health, Tampa, FL, 2004). The model is based on Soft Systems Methodology, an application of systems theory developed to facilitate practical action around systems change in human systems (Checkland in Systems thinking, systems practice, Wiley, Chichester, 1999). The implications of these findings to real world actions associated with systems change in systems of care are discussed.     

The Effect of Rehabilitation on Positive Interpretations of Illness

Postoperative patients received one of the three, alternative pain-management treatments: patient-controlled analgesia (PCA); perceived PCA (PPCA without actual control) and continuous intravenous infusion of analgesics (CII). Pain reports, morphine consumption and satisfaction of the groups were compared, and influences of individual differences in preferences for control and trait anxiety were tested. The main findings were: (1) PCA patients consumed less morphine and reported more pain and somewhat higher satisfaction; (2) PPCA patients were intermediate between the other two groups in pain reports and morphine consumption and lowest in satisfaction and (3) individual differences did not moderate the effects of PCA. The findings were interpreted as indicating that the main effect of PCA is increased pain tolerance, and that a bio-psycho-social framework is most appropriate to explain these effects.     

Comparison Blindness

Change blindness has been linked to comparisons over time when visual input is disturbed by a transient. This is most directly seen in “flicker” paradigms where change is invisible when introduced during a blank period between successive presentations of stimuli, and is implicit in paradigms where a stimulus is changed during a saccade. Difficulties in comparing two simultaneously present stimuli have been considered to be due to transaccadic memory limitations in tasks requiring saccades. We present here experiments that demonstrate the phenomenology of change blindness, but in tasks where two stimuli are present in the central visual field within a single fixation and where there are no transients present. These experiments are based on contrast discriminations of patterns composed of a few simple elements. We have found comparisons over space within a single fixation to be as difficult as comparisons over time. As in the more usual paradigms for change blindness, cueing makes changes easy to detect. These results suggest that a memory bottleneck is not essential to produce change blindness.     

Behavioral and neural correlates of disrupted orienting attention in posttraumatic stress disorder

Prior work has revealed that posttraumatic stress disorder (PTSD) is associated with altered (a) attentional performance and (b) resting-state functional connectivity (rsFC) in brain networks linked to attention. Here, we sought to characterize and link these behavioral and brain-based alterations in the context of Posner and Peterson’s tripartite model of attention. Male military veterans with PTSD (N = 49; all deployed to Iraq or Afghanistan) and healthy age-and-gender-matched community controls (N = 26) completed the Attention Network Task. A subset of these individuals (36 PTSD and 21 controls) also underwent functional magnetic resonance imaging (fMRI) to assess rsFC. The behavioral measures revealed that the PTSD group was impaired at disengaging spatial attention, relative to the control group. FMRI measures further revealed that, relative to the control group, the PTSD group exhibited greater rsFC between the salience network and (a) the default mode network, (b) the dorsal attention network, and (c) the ventral attention network. Moreover, problems with disengaging spatial attention increased the rsFC between the networks above in the control group, but not in the PTSD group. The present findings link PTSD to both altered orienting of spatial attention and altered relationships between spatial orienting and functional connectivity involving the salience network. Interventions that target orienting and disengaging spatial attention may be a new avenue for PTSD research.     

Neural circuitry of emotion regulation: Effects of appraisal,attention, and cortisol administration

Psychosocial well-being requires effective regulation of emotional responding in context of threat or stress. Neuroimaging studies have focused on instructed, volitional regulation (e.g., reappraisal or distancing), largely ignoring implicit regulation that does not involve purposeful effort to alter emotional experience. These implicit processes may or may not involve the same neural pathways as explicit regulatory strategies. We examined the neurobiology of implicit emotional regulation processes and the impact of the stress hormone cortisol on these processes. Our study task employed composite pictures of faces and places to examine neural activity during implicit emotional processing (of emotional faces), while these responses were implicitly regulated by attention shift away from the emotionally evocative stimuli, and while subjects reflectively appraised their own emotional response to them. Subjects completed the task in an fMRI scanner after random assignment to receive placebo or hydrocortisone (HCT), an orally administered version of cortisol. Implicit emotional processing activated insula/IFG, dACC/dMPFC, midbrain and amygdala. With attention shifting, we saw diminished signal in emotion generating/response regions (e.g., amygdala) and increased activations in task specific attention regions like parahippocampus. With appraisal of emotions, we observed robust activations in medial prefrontal areas, where activation is also seen in instructed reappraisal studies. We observed no main effects of HCT administration on brain, but males and females showed opposing neural effects in prefrontal areas. The data suggest that different types of emotion regulation utilize overlapping circuits, but with some strategy specific activation. Further study of the dimorphic sex response to cortisol is needed.     

Pentecostal Dynamics of African Initiated Churches

This essay is a historical consideration of the body of churches known as African Initiated Churches (AICs). The key research questions I am investigating are whether this church can be classified as Pentecostal and how it employs transnational networking in its mission strategy. I have approached this question by exploring the Pentecostal dynamics and transnational networking of the Cherubim and Seraphim Church as an example of an AIC. To this end, I analyze the Pentecostal and transnational nature of an international ecumenical conference organized by the church in London in 2017. This essay is written from the perspective of someone who was born and raised within the church movement, but has also studied the movement as part of African Christianity. The originality of this essay is in its analysis of the transnational nature of the international ecumenical conference.     

Recent research on children’s testimony about experienced and witnessed events

Research on memory development has increasingly moved out of the laboratory and into the real world. Whereas early researchers asked whether confusion and susceptibility to suggestion made children unreliable witnesses, furthermore, contemporary researchers are addressing a much broader range of questions about children’s memory, focusing not only on children’s frailties but also on their competencies. In this review, we emphasize work on factors that promote the retrieval and accurate recounting of experienced or witnessed events and the implications of these findings for forensic interview practices. Research shows that children are capable of providing accurate information about their experiences, although their ability to convey the information is affected not only by the qualities of their memories, but also by the types of retrieval mechanisms employed and the quality of the communication between them and their interlocutors. We thus discuss several characteristics of to-be-remembered events that affect memory and are relevant to children’s recall in applied settings; retrieval conditions and their effects on the amount and accuracy of the information that children report; and research on investigative interviews conducted in forensic contexts. Because many of the variables that influence memory are age-related, developmental changes in children’s ability to accurately report, and recount their experiences are highlighted.     

Inaction Inertia in the Stock Market1

Based on the inaction inertia effect, it was hypothesized that investors who missed an opportunity to leave a “bear market” will be less likely to sell the stock at a later opportunity when facing a grave loss. Participants in a stock‐market computer game were given an opportunity to sell their stock for a moderate gain. Having missed this initial opportunity and now facing a grave loss, these participants were less likely to sell their stock compared to participants whose potential loss was not as grave, or compared to participants facing the same magnitude of loss who had no previous opportunity to leave the market. Analysis of the time spent by participants on reading relevant information concerning the stock market suggests that this tendency toward continued inaction was not the result of careful deliberation over market trends. The results are discussed in terms of counterfac‐tual thinking and anticipated regret.