Is obsessive-compulsive disorder caused by a second-messenger imbalance?

Although the precise etiologic nature of obsessive-compulsive disorder (OCD), one of the most common psychiatric conditions, is unknown, several findings indicate involvement of the serotonin (5-HT) transporter. Apart from the specific effects of selective 5-HT reuptake inhibitors, other studies show decreased functionality of the platelet 5-HT transporter in OCD. In this report, the authors combine data from two independent studies of patients with OCD, showing both an increased activity of protein kinase type C (PKC) and a decreased activity of protein kinase type A (PKA). The authors propose a unifying hypothesis that OCD might be determined by an imbalance between PKC and PKA, with a prevalence of the former and, more generally, of the phosphoinositide over the cyclic adenosine monophosophate (cAMP) pathway. Should this hypothesis prove correct, the path would be open for new therapeutic interventions in the treatment of OCD.     

Anxiety sensitivity as a specific and unique marker of anxious symptoms in youth psychiatric inpatients

We addressed several questions regarding the relation of anxiety sensitivity to anxious symptoms among 47 youth psychiatric inpatients (18 boys, 29 girls), ages 9–17 (M = 14.23, SD = 1.89). Participants completed measures of anxiety sensitivity, anxious and depressive symptoms, trait anxiety, and positive and negative affect; chart diagnoses were available. Consistent with hypotheses, we found that (a) anxiety sensitivity was associated with anxious symptoms, even controlling for trait anxiety and depressive symptoms; and (b) anxiety sensitivity displayed symptom specificity to anxious versus depressive symptoms (i.e., was associated with anxiety controlling for depression but not with depression controlling for anxiety). Furthermore, regarding factors of anxiety sensitivity, we obtained mixed support for our prediction that phrenophobia would be associated with both depression and anxiety, whereas fear of physical arousal would be associated with anxiety but not depression. Implications for the construct validity of anxiety sensitivity were discussed.     

Gathering Diverse Perspectives to Tackle “Wicked Problems”: Racial/Ethnic Disproportionality in Educational Placement

Among students receiving behavioral health and special education services, racial/ethnic minority students are consistently overrepresented in settings separate from general classrooms. Once separated, many young people struggle to improve academically and face significant difficulty upon trying to return to a general education setting. Given the complex, ongoing, and multifaceted nature of this challenge, racial/ethnic disproportionality can be identified as a “wicked problem,” for which solutions are not easily identified. Here, we describe our community-engaged research efforts, eliciting perspectives from relevant partners in an ongoing dialogue, to better integrate diverse stakeholders’ perspectives when attempting to address such disparities. We conducted focus groups and qualitative interviews with members of three stakeholder groups: community-serving organizations, individuals with lived experience of behavioral health conditions, and state-level policymakers, with a shared interest in addressing racial and ethnic disparities. Participant responses illustrated the “wickedness” of this problem and highlighted the need for additional supports for students, families, and school personnel, increased collaboration across relevant systems and agencies, and reduced barriers related to funding. Overall, this methodology bridged differing perspectives to develop, in concert with our partners, a shared language of the problem and a core set of issues to consider when seeking to effect change.     

Adjacent and Non-Adjacent Word Contexts Both Predict Age of Acquisition of English Words: A Distributional Corpus Analysis of Child-Directed Speech

Children show a remarkable degree of consistency in learning some words earlier than others. What patterns of word usage predict variations among words in age of acquisition? We use distributional analysis of a naturalistic corpus of child-directed speech to create quantitative features representing natural variability in word contexts. We evaluate two sets of features: One set is generated from the distribution of words into frames defined by the two adjacent words. These features primarily encode syntactic aspects of word usage. The other set is generated from non-adjacent co-occurrences between words. These features encode complementary thematic aspects of word usage. Regression models using these distributional features to predict age of acquisition of 656 early-acquired English words indicate that both types of features improve predictions over simpler models based on frequency and appearance in salient or simple utterance contexts. Syntactic features were stronger predictors of children's production than comprehension, whereas thematic features were stronger predictors of comprehension. Overall, earlier acquisition was predicted by features representing frames that select for nouns and verbs, and by thematic content related to food and face-to-face play topics; later acquisition was predicted by features representing frames that select for pronouns and question words, and by content related to narratives and object play.     

Next Generation Sequencing in the Clinic: a Patterns of Care Study in a Retrospective Cohort of Subjects Referred to a Genetic Medicine Clinic for Suspected Lynch Syndrome

Next generation sequencing (NGS) gene panels are increasingly used in medical genetics clinics for the evaluation of common inherited cancer syndromes, but the clinical efficacy of these tests, and the factors driving clinical providers to order them are unclear. We conducted a patterns-of-care study to compare patients evaluated with NGS gene panels with a reference group. We abstracted demographic, socioeconomic, and clinical information in a retrospective cohort of patients referred to a large medical genetics clinic for evaluation of inherited colorectal cancer and polyposis syndromes. Patients tested with NGS gene panels were more likely to be insured compared to the reference group (85.3 % vs. 69.2 %, p = 0.0068),less likely to have prior tumor tissue testing (29.4 % vs. 54.3 %, p = 0.0004), and less likely to have an abnormal tumor tissue test result (46.7 % vs. 74.5 %, p = 0.01). No significant differences were found between groups in age, gender, race, employment status, personal history of colorectal cancer, or proportion of patients fulfilling Lynch syndrome clinical criteria. Patients with NGS testing were less likely to have a pathogenic/likely pathogenic variant detected (13.7 % vs. 31.9 %, p = 0.002). Patients referred for NGS testing to evaluate inherited colorectal cancer/polyposis risk appear to undergo tumor tissue testing less frequently than non-NGS testing patients. Further studies are needed to assess the most effective and cost-effective approach to genomic diagnosis in this patient population.     

A dual-motive model of scapegoating: displacing blame to reduce guilt or increase control

The authors present a model that specifies 2 psychological motives underlying scapegoating, defined as attributing inordinate blame for a negative outcome to a target individual or group, (a) maintaining perceived personal moral value by minimizing feelings of guilt over one's responsibility for a negative outcome and (b) maintaining perceived personal control by obtaining a clear explanation for a negative outcome that otherwise seems inexplicable. Three studies supported hypotheses derived from this dual-motive model. Framing a negative outcome (environmental destruction or climate change) as caused by one's own harmful actions (value threat) or unknown sources (control threat) both increased scapegoating, and these effects occurred indirectly through feelings of guilt and perceived personal control, respectively (Study 1), and were differentially moderated by affirmations of moral value and personal control (Study 2). Also, scapegoating in response to value threat versus control threat produced divergent, theoretically specified effects on self-perceptions and behavioral intentions (Study 3).