HPA-Axis Activation as a Key Moderator of Childhood Trauma Exposure and Adolescent Mental Health

Individual differences in a child’s sensitivity to stress may influence whether youth exposed to trauma develop symptoms of psychopathology. We examined the interaction between HPA-axis reactivity to an acute stressor and exposure to different types of childhood trauma as predictors of mental health symptoms in a sample of youth. Youth (n?=?121, ages 9–16; 47% female) completed a standardized stress task, including 5 post-stress salivary cortisol samples. Parents also completed the Child Behavior Checklist as a measure of child internalizing and externalizing symptoms in the past month, and completed the Early Trauma Inventory (ETI) as a measure of their child’s trauma exposure. More emotional abuse and non-intentional trauma were associated with greater internalizing symptoms. Youth exposed to physical abuse who demonstrated slower HPA-axis reactivity had elevated internalizing and externalizing symptoms. Youth exposed to emotional abuse or non-intentional traumatic events who demonstrated faster HPA-axis reactivity had elevated internalizing and externalizing symptoms. Profiles of exaggerated or attenuated HPA-axis reactivity to acute stress may be risk factors for psychopathology in children facing different stressful social environments.     

Implementing a Virtual Health Telemedicine Program in a Community Setting

Aurora Health Care in eastern Wisconsin has a clinical genetics program driven by genetic counselors in the cancer/adult and prenatal genetics settings. In 2015, the workforce shortage of genetic counselors left us with 4 open positions for genetic counselors that we were unable to fill. We explored many models of alternative service delivery, and determined virtual health (VH) via telemedicine to be the best option for our system. Historically, telemedicine technologies have been used to provide access to healthcare services to patients in remote areas. We, however, were struggling to find genetics counselors to staff both our remote clinics and urban clinics. To solve this problem, we recruited genetic counselors from across the country to work remotely from their current home or home office utilizing VH to staff our clinics. We then created clinical workflows and an implementation process of virtual health for 9 prenatal and cancer clinics across the eastern Wisconsin footprint of our healthcare system over the course of 12 months. Here we provide our experience and process in establishing a VH program in order to help other institutions that have been affected by the workforce shortage of clinical genetics professionals.     

Using self‐monitoring and differential reinforcement of low rates of behavior to decrease repetitive behaviors: A case study

We used a reversal design to evaluate the effects of a self‐monitoring system and differential reinforcement of low rates of behavior on decreasing repetitive body movements in a child with autism. A trial‐based functional analysis revealed that repetitive body movements were maintained by automatic reinforcement. Treatment consisted of teaching the participant to use a self‐monitoring system to monitor the occurrence of repetitive body movements. A stimulus control analysis revealed the self‐monitoring system acquired stimulus control over the repetitive body movements, in that they were more likely to occur in the absence of the system than in its presence. The self‐monitoring system was implemented with a differential reinforcement of low rates of behavior, and their combined effects were evaluated within a reversal design. Repetitive body movements decreased with the implementation of the treatment. The use of self‐monitoring systems to target problem behavior is discussed.     

Comparing implicit and explicit attitudes of gay,straight, and non-monosexual groups toward transmen and transwomen

Background: Transphobia studies have typically relied on self-report measures from heterosexual samples. However, there is evidence suggesting the need to use indirect measures and to explore transphobia among other populations. Aims: This study examined how explicit and implicit attitudes toward transwomen and transmen differ between people of different sexual orientations. Methods: Cisgender participants (N = 265) completed measures of explicit feelings toward transmen and transwomen, as well as Implicit Association Tests (IAT) for each group. Comparisons were made between 54 gay, 79 straight, and 132 non-monosexual (asexual, bisexual, pansexual) individuals. Results: An interaction was found between measurement type (explicit, implicit) and sexual orientation (straight, gay, non-monosexual). With regard to transmen, gay respondents’ explicit and implicit scores diverged such that they explicitly reported lower bias than their straight counterparts, but their Transmen-IAT showed an implicit preference for biological men over transmen. For attitudes toward transwomen, implicit measurement scores were consistently negative and did not differ by group. Gay participants also reported positive explicit attitudes toward transwomen, similar to non-monosexual people. Discussion: Overall, findings show that gay people tend to report positive attitudes toward transgender people explicitly, but tend to have implicit bias against both transmen and transwomen. Future studies need to explore the origins of these biases and how they relate to the complex interplay of sex, gender, and sexual orientation.     

The influence of visual flow and perceptual load on locomotion speed

Visual flow is used to perceive and regulate movement speed during locomotion. We assessed the extent to which variation in flow from the ground plane, arising from static visual textures, influences locomotion speed under conditions of concurrent perceptual load. In two experiments, participants walked over a 12-m projected walkway that consisted of stripes that were oriented orthogonal to the walking direction. In the critical conditions, the frequency of the stripes increased or decreased. We observed small, but consistent effects on walking speed, so that participants were walking slower when the frequency increased compared to when the frequency decreased. This basic effect suggests that participants interpreted the change in visual flow in these conditions as at least partly due to a change in their own movement speed, and counteracted such a change by speeding up or slowing down. Critically, these effects were magnified under conditions of low perceptual load and a locus of attention near the ground plane. Our findings suggest that the contribution of vision in the control of ongoing locomotion is relatively fluid and dependent on ongoing perceptual (and perhaps more generally cognitive) task demands.     

Sleep and Sleep Disorders in Older Adults

A common but significant change associated with aging is a profound disruption to the daily sleep-wake cycle. It has been estimated that as many as 50% of older adults complain about difficulty initiating or maintaining sleep. Poor sleep results in increased risk of significant morbidity and mortality. Moreover, in younger adults, compromised sleep has been shown to have a consistent effect on cognitive function, which may suggest that sleep problems contribute to the cognitive changes that accompany older age. The multifactorial nature of variables affecting sleep in old age cannot be overstated. Changes in sleep have been thought to reflect normal developmental processes, which can be further compromised by sleep disturbances secondary to medical or psychiatric diseases (e.g., chronic pain, dementia, depression), a primary sleep disorder that can itself be age-related (e.g., Sleep Disordered Breathing and Periodic Limb Movements During Sleep), or some combination of any of these factors. Given that changes in sleep quality and quantity in later life have implications for quality of life and level of functioning, it is imperative to distinguish the normal age-related sleep changes from those originating from pathological processes.     

Complaining about a compliment: Evaluating attributions of positive outcomes to discrimination

People evaluate stigmatized group members negatively when they attribute negative personal outcomes to discrimination, even when discrimination is the likely cause. The present studies examined whether similar interpersonal costs exist for attributing a positive personal outcome to discrimination in the context of positive stereotypes. In Study 1, 129 participants read an excerpt written by an Asian student who attributed an unexpectedly high essay grade to discrimination, writing quality, or easy grading. Participants evaluated the student least favourably when he attributed the positive outcome to discrimination. In Study 2, 140 participants evaluated a successful Asian job applicant less favourably than a successful, white applicant, although both applicants attributed the positive outcome to group membership. The implications for how stigmatized group members perceive and respond to prejudice and discrimination are discussed.     

Horses (<Emphasis Type="Italic">Equus caballus</Emphasis>) use human local enhancement cues and adjust to human attention

This study evaluates the horse (Equus caballus) use of human local enhancement cues and reaction to human attention when making feeding decisions. The superior performance of dogs in observing human states of attention suggests this ability evolved with domestication. However, some species show an improved ability to read human cues through socialization and training. We observed 60 horses approach a bucket with feed in a three-way object-choice task when confronted with (a) an unfamiliar or (b) a familiar person in 4 different situations: (1) squatting behind the bucket, facing the horse (2) standing behind the bucket, facing the horse (3) standing behind the bucket in a back-turned position, gazing away from the horse and (4) standing a few meters from the bucket in a distant, back-turned position, again gazing away from the horse. Additionally, postures 1 and 2 were tested both with the person looking permanently at the horse and with the person alternating their gaze between the horse and the bucket. When the person remained behind the correct bucket, it was chosen significantly above chance. However, when the test person was turned and distant from the buckets, the horses’ performance deteriorated. In the turned person situations, the horses approached a familiar person and walked towards their focus of attention significantly more often than with an unfamiliar person. Additionally, in the squatting and standing person situations, some horses approached the person before approaching the correct bucket. This happened more with a familiar person. We therefore conclude that horses can use humans as a local enhancement cue independently of their body posture or gaze consistency when the persons remain close to the food source and that horses seem to orientate on the attention of familiar more than of unfamiliar persons. We suggest that socialization and training improve the ability of horses to read human cues.