ABSTRACT IMPACT: A better understanding of the spectrum of problematic opioid use will lead to more targeted treatments. OBJECTIVES/GOALS: It is unclear how to approach treatment of individuals with problematic opioid use who do not clearly meet criteria for opioid use disorder (OUD). We aim to characterize clinical, demographic, and medication use at time of identification of problematic opioid use across the spectrum as well as identify predictors of poor outcomes. METHODS/STUDY POPULATION: A national sample of Veterans coded as having opioid abuse or dependence were previously categorized as (1) high likelihood of OUD, (2) limited aberrant opioid use, and (3) prescribed opioid use with no evidence of aberrant use based on chart review. We will describe how individuals in these three categories differ demographically and clinically. We will then use a trained binary logistic regression model to predict whether individuals with limited aberrant opioid use more closely resemble category (1) or (3). Cox proportional hazards models will be used to predict all-cause mortality, suicide-related mortality, opioid-overdose related mortality, and hospitalization over a three-year period using the three categories as predictors and adjusting for relevant covariates. RESULTS/ANTICIPATED RESULTS: We anticipate that Veterans with a high likelihood of OUD will be more likely to experience homelessness and have more psychiatric comorbidities (especially PTSD). We hypothesize that Veterans with prescribed opioid use and no evidence of misuse will be significantly older, more likely to have disability, medical comorbidities (ie., chronic pain, cancer), more prescriptions for non-opioid analgesics, and be prescribed higher doses of opioids. Using a trained binary logistic regression model, we predict that Veterans with limited aberrant opioid use will more closely resemble Veterans with a high likelihood of OUD. We expect that all categories of problematic opioid use will have a high risk of mortality, with a high likelihood of OUD associated with the greatest risk of premature death. DISCUSSION/SIGNIFICANCE OF FINDINGS: Identifying and better characterizing individuals with limited aberrant opioid use may be an important opportunity to intervene prior to development of severe OUD. Future research will focus on targeting interventions to this population, which may have specific needs that are separate from classic OUD or simple pain-related opioid dependence.

This paper provides a critical rejoinder to some themes in Kyle Johannsen’s A Conceptual Investigation of Justice. The discussion focuses on Johannsen’s analysis of fundamental value pluralism and identifies a number of challenges to the form of value pluralism defended by Johannsen. I suggest that Johannsen’s analysis fails to explain how conflicts between fundamental values can be resolved, and that there is greater harmony between fundamental values than Johannsen recognizes.

Mental imagery refers to the experience of perception in the absence of external sensory input. Deficits in the ability to generate mental imagery or to distinguish it from actual sensory perception are linked to neurocognitive conditions such as dementia and schizophrenia, respectively. However, the importance of mental imagery to psychiatry extends beyond neurocognitive impairment. Mental imagery has a stronger link to emotion than verbal-linguistic cognition, serving to maintain and amplify emotional states, with downstream impacts on motivation and behavior. As a result, anomalies in the occurrence of emotion-laden mental imagery has transdiagnostic significance for emotion, motivation, and behavioral dysfunction across mental disorders. This review aims to demonstrate the conceptual and clinical significance of mental imagery in psychiatry through examples of mood and anxiety disorders, self-harm and suicidality, and addiction. We contend that focusing on mental imagery assessment in research and clinical practice can increase our understanding of the cognitive basis of psychopathology in mental disorders, with the potential to drive the development of algorithms to aid treatment decision-making and inform transdiagnostic treatment innovation.

If meta-analysis is to provide valuable answers, then it is critical to ensure clarity about the questions being asked. Here, we distinguish two important questions concerning cognitive bias modification research that are not differentiated in the meta-analysis recently published by Cristea et al (2015) in this journal: (1) do the varying procedures that investigators have employed with the intention of modifying cognitive bias, on average, significantly impact emotional vulnerability?; and (2) does the process of successfully modifying cognitive bias, on average, significantly impact emotional vulnerability? We reanalyse the data from Cristea et al to address this latter question. Our new analyses demonstrate that successfully modifying cognitive bias does significantly alter emotional vulnerability. We revisit Cristea et al's conclusions in light of these findings.

While control conditions are vitally important in research, selecting the optimal control condition can be challenging. Problems are likely to arise when the choice of control condition is not tightly guided by the specific question that a given study aims to address. Such problems have become increasingly apparent in experimental psychopathology research investigating the experimental modification of cognitive biases, particularly as the focus of this research has shifted from theoretical questions concerning mechanistic aspects of the association between cognitive bias and emotional vulnerability, to questions that instead concern the clinical efficacy of ‘cognitive bias modification’ (CBM) procedures. We discuss the kinds of control conditions that have typically been employed in CBM research, illustrating how difficulties can arise when changes in the types of research questions asked are not accompanied by changes in the control conditions employed. Crucially, claims made on the basis of comparing active and control conditions within CBM studies should be restricted to those conclusions allowed by the specific control condition employed. CBM studies aiming to establish clinical utility are likely to require quite different control conditions from CBM studies aiming to illuminate mechanisms. Further, conclusions concerning the clinical utility of CBM interventions cannot necessarily be drawn from studies in which the control condition has been chosen to answer questions concerning mechanisms. Appreciating the need to appropriately alter control conditions in the transition from basic mechanisms-focussed investigations to applied clinical research could greatly facilitate the translational process.

The perfectly competitive market of economic theory often enters political philosophy because it can be represented as illuminating important values. Theorists who are enthusiastic about the heuristic potential of the market claim that we can learn much about individual liberty, the promotion of mutual advantage and efficiency in the distribution of goods by studying it. However, a principal limitation of the market for many theorists is its supposed insensitivity to the demands of egalitarian justice. According to the standard charge, markets—even idealised ones—are hostile to the achievement and maintenance of an equitable distribution of resources. It is striking, then, that a leading exponent of egalitarian justice like Ronald Dworkin should argue that there are very deep and systematic links between equality and the market. He contends that, contrary to the received view, “the best theory of equality supposes some actual or hypothetical market in justifying a particular distribution of goods and opportunities.” Moreover, the articulation of Dworkin’s influential egalitarian account of liberal political morality depends on acceptance of the market as an ally of equality. Thus Dworkin claims not only that the market plays a crucial role in the elaboration of a doctrine of distributive justice but also that it illuminates the distinctively liberal commitments to the protection of extensive individual liberty and to the requirement that the state must be neutral between different conceptions of the good. The aim of this paper is to raise some doubts about the soundness of one of the fundamental onnections Dworkin draws between the market and distributive justice.

This paper critically examines the recent impact of cognitivism upon the field of clinical psychology, and concludes that certain criteria of scientific adequacy have been compromised. The argument is developed that the introduction of information processing constructs to theoretical models of psychopathology has made a potentially valuable contribution to the discipline; but that the acceptance of mental events as dependent measures has severely undermined the scientific credibility of experimental attempts to evaluate such models. It is proposed that future progress will require the adoption of a particular methodological constraint. Specifically, it is suggested that cognitive explanations of psychopathology can only be tested adequately by evaluating the validity of the behavioural predictions that they generate. Using examples of recent research that has investigated the cognitive characteristics of vulnerability to anxiety and depression, an attempt is made to demonstrate that adherence to this proposed constraint not only is possible, but actually provides a far greater degree of understanding than could be attained through the use of alternative methodologies. It is postulated that the future scientific status of clinical psychology may depend upon our collective response to the issues that are raised in this paper.

Peaks in northern bottlenose whale, Hyperoodon ampullatus, strandings are found between August and September in the UK and August and November in The Netherlands, consistent with a hypothesized southward migration. However, results on diet suggest that several whales stranded during these months were not travelling from northern latitudes prior to stranding. We analysed the stomach contents of ten whales stranded in the north-east Atlantic (Scotland, N = 6, England, N = 1, Ireland, N = 2 and The Netherlands, N = 1). All but one of the analysed whales (live-stranded in the River Thames in January 2006) stranded between August and October. Food remains consisted almost entirely of cephalopod mandibles. Twenty-one cephalopod species (16 families) were recorded, the most abundant taxa being Gonatus spp., Teuthowenia spp. and Taonius pavo. No fish and few crustacean remains were found. Small amounts of cephalopod flesh were found in three of the stomachs and none in the others. Given that cephalopod beaks can remain within the stomach for several days, and that there was no evidence of inshore feeding (no coastal species were present among the prey), the whales may not have fed for several days prior to stranding. Three whales had remains of warm-temperate water cephalopods (e.g. Vampyroteuthis infernalis, Heteroteuthis sp.) in their stomachs, while three individuals showed a high diversity of prey in their stomachs, suggesting that several of the whales could have been either travelling north or consistently feeding in temperate latitudes prior to stranding. As previously recorded in other deep diving teuthophagous cetaceans, two animals had ingested small amounts of plastic debris.

The waters off north-west Scotland are known to provide important habitat for the harbour porpoise (Phocoena phocoena) and the minke whale (Balaenoptera acutorostrata). Between October 2008 and April 2011, systematic land-based surveys were carried out to assess the seasonal occurrence, group size and group behaviours of both species in a study area located off Melvaig, near Gairloch. Data were collected on 47 separate days, with a total of 4543 minutes of survey effort (in sea states ≤3) recorded during the spring months and 8204 minutes of effort during the autumn. A total of 189 sightings of marine fauna were recorded, comprising 126 cetacean sightings, 50 seal sightings and 13 sightings of basking sharks (Cetorhinus maximus). Six species of cetacean were identified, with most sightings comprising harbour porpoise (N = 72) or minke whale (N = 38). Harbour porpoise abundance was higher in autumn than in spring and there was a variation between years in numbers of minke whales sighted. In porpoises, sea state and cloud cover both influenced sightings and increasing sea state influenced survey area. Foraging behaviour was exhibited in 13% of harbour porpoise sightings and 34% of minke whale sightings. Results demonstrate a regular occurrence of harbour porpoises and minke whales in nearshore waters off Gairloch. Densities are comparable to boat surveys in the region and so support the use of land-based watches as a potential longer-term monitoring method for these species in coastal waters. Given the regular use of this area by these two European Protected Species, as well as the occurrence of a range of human activities potentially affecting them in the region, it may be appropriate to consider protecting this area for their conservation.

The habitat preferences and niches of eight cetacean species inhabiting eastern tropical Atlantic waters between Angola and Gabon (1°N–11°S latitude) were examined. A total of 2873 cetacean sightings, recorded between January 2004 and June 2009, was assigned to 10 × 10 km grid cells and linked to four ecogeographical variables (EGVs): water depth, seabed slope, sea surface temperature (SST) and relative frontal strength. Classification trees revealed that the habitat preferences (in terms of the habitats sampled) of most species were primarily determined by SST (for Bryde's whale, sperm whale, short-finned pilot whale and common dolphin) and water depth (for Risso's dolphin, bottlenose dolphin and Atlantic spotted dolphin). Seabed slope was the most important EGV describing the presence of the striped dolphin. A principal component analysis was used to compare the niches of the species with respect to the four EGVs. Nineteen species pairs (68%) differed significantly in median principal component (PC) score for the first PC axis, suggesting differences in their niche centres for that axis. Sixteen species pairs (57%) differed significantly in PC score variance suggesting differences in the niche widths along the first PC axis. Water depth and SST were the most important variables for the first PC axis. Together, these results suggest that cetacean species inhabiting the eastern tropical Atlantic exhibit interspecific variation in their habitat preferences, and so differ in the niches that they occupy. These differences are most likely related to variation in prey species and foraging strategy.

On 8 May 2010, a gray whale was sighted off the Israeli Mediterranean shore and twenty-two days later, the same individual was sighted in Spanish Mediterranean waters. Since gray whales were last recorded in the North Atlantic in the 1700s, these sightings prompted much speculation about this whale's population origin. Here, we consider three hypotheses for the origin of this individual: (1) it represents a vagrant individual from the larger extant population of gray whales found in the eastern North Pacific; (2) it represents a vagrant individual from the smaller extant population found in the western North Pacific; or (3) it represents an individual from the previously thought extinct North Atlantic population. We believe that the first is the most likely, based on current population sizes, on known summer distributions, on the extent of cetacean monitoring in the North Atlantic and on the results of a performed route analysis. While it is difficult to draw conclusions from such singular events, the occurrence of this individual in the Mediterranean coincides with a shrinking of Arctic Sea ice due to climate change and suggests that climate change may allow gray whales to re-colonize the North Atlantic as ice and temperature barriers to mixing between northern North Atlantic and North Pacific biomes are reduced. Such mixing, if it were to become widespread, would have implications for many aspects of the marine conservation and ecology of these two regions.