Risk-factor research and prevention programs for anxiety disorders: a translational research framework

The aim of the present essay is to discuss the interconnection between risk-factor research and prevention program development for panic-spectrum psychopathology. We argue that prevention of panic-spectrum psychopathology specifically, and anxiety disorders more generally, is likely to be best advanced through active, systematic translation of basic, risk-factor research. After operationalizing key terminology, we present some exemplar risk-factor candidates for panic-spectrum psychopathology, summarize research related to their role as risk-factors for panic problems, and link this discussion to risk-factor nomenclature. We then present a translational framework for extrapolating extant knowledge on these and other potential risk-factors for panic-spectrum psychopathology with respect to the development of preventative interventions. The proposed translational framework is intended to describe a forward-feeding process by which risk-factor research could be used by clinical researchers to inform prevention programs; and reciprocally, how such prevention knowledge could be most effectively utilized to drive new, clinically focused risk-factor research.     

Does Free Will Remain a Mystery? A Response to Van Inwagen

In this paper, I argue against Peter van Inwagen’s claim (in “Free Will Remains a Mystery”), that agent-causal views of free will could do nothing to solve the problem of free will (specifically, the problem of chanciness). After explaining van Inwagen’s argument, I argue that he does not consider all possible manifestations of the agent-causal position. More importantly, I claim that, in any case, van Inwagen appears to have mischaracterized the problem in some crucial ways. Once we are clear on the true nature of the problem of chanciness, agent-causal views do much to eradicate it.     

SNRIs: their pharmacology, clinical efficacy, and tolerability in comparison with other classes of antidepressants

The class of serotonin and norepinephrine reuptake inhibitors (SNRIs) now comprises three medications: venlafaxine, milnacipran, and duloxetine. These drugs block the reuptake of both serotonin (5-HT) and norepinephrine with differing selectivity. Whereas milnacipran blocks 5-HT and norepinephrine reuptake with equal affinity, duloxetine has a 10-fold selectivity for 5-HT and venlafaxine a 30-fold selectivity for 5-HT. All three SNRIs are efficacious in treating a variety of anxiety disorders. There is no evidence for major differences between SNRIs and SSRIs in their efficacy in treating anxiety disorders. In contrast to SSRIs, which are generally ineffective in treating chronic pain, all three SNRIs seem to be helpful in relieving chronic pain associated with and independent of depression. Tolerability of an SNRI at therapeutic doses varies within the class. Although no direct comparative data are available, venlafaxine seems to be the least well-tolerated, combining serotonergic adverse effects (nausea, sexual dysfunction, withdrawal problems) with a dose-dependent cardiovascular phenomenon, principally hypertension. Duloxetine and milnacipran appear better tolerated and essentially devoid of cardiovascular toxicity.     

Temporal integration differences between crossed and uncrossed stereoscopic mechanisms

In this study, we investigated temporal integration of disparity information for crossed and uncrossed stereopsis. Across three experiments, exposure duration thresholds were measured for stereoscopic stimuli created from dynamic random-dot stereograms. In Experiment 1, an investigation of disparity detection showed that detection thresholds were equal for the crossed and uncrossed directions. In Experiment 2, an examination of duration limits for depth perception showed that critical durations were lower, and depth more veridical, for crossed depth than for uncrossed depth. In Experiment 3, an investigation of depth discrimination revealed that discrimination thresholds were lower for crossed depth than for uncrossed depth. These results suggest that crossed and uncrossed mechanisms differ in terms of their temporal integration properties at processing levels involving the computation and discrimination of depth.     

Childhood Executive Function Continues to Predict Outcomes in Young Adult Females with and Without Childhood-Diagnosed ADHD

We prospectively followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n?=?140) and matched comparison girls (n?=?88) over a period of 10?years, from middle childhood through late adolescence/young adulthood. Our aim was to examine the ability of childhood measures of executive function (EF) to predict functional outcomes at follow-up. Measures of EF comprised the childhood predictors, with academic, socioemotional, occupational, and global functioning serving as young adult criterion measures. Results indicated that childhood EF - particularly measures of global EF and working memory - predicted academic and occupational functioning across our entire sample (independent of diagnostic group status), but diagnostic status (ADHD versus comparison) moderated the association between (a) working memory and reading achievement and (b) a global EF measure and suspensions/expulsions. That is, in the ADHD group, low working memory predicted poor reading scores and impaired global EF predicted higher suspensions/expulsions, but this was not the case in the comparison group. Overall, these results extend previous findings of associations between EF and adolescent outcomes in girls with and without ADHD into young adulthood. Findings continue to suggest the importance of assessing and developing interventions that target EF impairments early in life in order to prevent long-term difficulties across a range of important functional domains.     

The impact of optimality on maternal sensitivity in mothers with substance abuse and psychiatric problems and their infants at 3 months

The main aim of this study was to investigate the predictive validity of four different optimality indexes, as well as infant perinatal status, in relation to maternal sensitivity in interaction at 3 months. The four optimality indexes comprised items related to substance abuse, psychiatric condition, relational experience and socioeconomic status (SES). Maternal sensitivity in mother-infant interaction was assessed in two different groups of mothers. One group consisted of mothers with substance abuse and psychiatric problems who underwent treatment during pregnancy. The other group of mothers had neither substance abuse nor psychiatric problems. The expectant mothers were interviewed in the third trimester of pregnancy. Medical records and meconium were obtained from the infants at birth. Three months after birth, maternal sensitivity in mother-infant interaction was assessed. Altogether 79 mother-infant dyads participated in the study. The mothers' optimality associated with relational experiences, as well as the infants' perinatal status were found to predict maternal sensitivity in mother-infant interaction at 3 months. The SES index was also significantly related to maternal sensitivity. The relation between group and maternal sensitivity was mediated by the mothers' optimality associated with relational experiences. This study points to the importance of addressing the mothers' own relational experiences and their current representations of motherhood during treatment, in order to support and enhance maternal sensitivity.     

VA Puget Sound Telemental Health Service to rural veterans: a growing program

The VA Puget Sound Health Care System Telemental Health program connects veterans with psychologists, psychiatrists, and social workers via live clinical video teleconferencing. Providers deliver care to veterans in rural Veteran Affairs medical centers, community-based outpatient clinics and residences, and thus, increase access to specialty mental health care for rural and medically underserved veteran communities.     

Considering J.Lo and Ugly Betty: a qualitative examination of risk factors and prevention targets for body dissatisfaction, eating disorders, and obesity in young Latina women

Latina women are vulnerable to poor body image, eating disorders, and obesity, particularly during the college years. This study sought to identify common cultural antecedents of these concerns in order to inform the development of prevention programs for this population. Six groups of university students who identified as Latina (N=27) discussed cultural aspects of body image, eating disorders, and obesity. Thematic analysis identified four main themes: (a) cultural disparities in body-ideal, including the influence of the media and acculturation issues; (b) messages about body shape and weight received by family, peers, and society; (c) difficulties making healthy eating and physical activity choices as a function of college life; and (d) the influence of peers and potential male partners on body satisfaction and body-ideals. These results have implications for the development of programs targeting body dissatisfaction and risk for eating disorders and obesity in Latina college women.     

Age-related influences on lexical selection and orthographic encoding during homophone spelling

Two experiments investigated age differences in how semantic, syntactic, and orthographic factors influence the production of homophone spelling errors in sentence contexts. Younger and older adults typed auditorily presented sentences containing homophone targets (e.g., blew) that were categorized as having a regular spelling (EW) or an irregular spelling (UE). In Experiment 1, homophones were preceded by an unrelated word, a semantic prime that was congruent with the target's meaning in the sentence (e.g., wind), or a semantic prime incongruent with the target's meaning (e.g., sky) and instead related to the competitor homophone. Experiment 2 manipulated the target's part of speech, where target and competitor homophones shared or differed in part of speech. For both age groups, significant semantic priming occurred, where homophone errors decreased following congruent semantic primes and increased following incongruent primes. However, priming only occurred when homophones shared part of speech. Further, both age groups made more errors on homophones with an irregular than a regular spelling, and this regularity effect was smaller for older adults when homophones shared part of speech. Contrary to many spoken production tasks, older adults made fewer errors overall than younger adults. These findings demonstrate age preservation in lexical selection but age differences in orthographic encoding, resulting in older adults producing fewer errors because of reduced activation to competitor homophones. These findings also illustrate that syntactic factors, such as part of speech, can influence the spellings of individual words.     

Establishing a Valid,Reliable, and Efficient Chart Review Process for Research in Pediatric Integrated Primary Care Psychology

Journal of Clinical Psychology in Medical Settings - Retrospective chart review is an accessible form of research that is commonly used across medical fields but is underutilized in behavioral...