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While negative affect reliably predicts binge eating, it is unknown how this association may decrease or ‘de-couple’ during treatment for binge eating disorder (BED), whether such change is greater in treatments targeting emotion regulation, or how such change predicts outcome. This study utilized multi-wave ecological momentary assessment (EMA) to assess changes in the momentary association between negative affect and subsequent binge-eating symptoms during Integrative Cognitive Affective Therapy (ICAT-BED) and Cognitive Behavior Therapy Guided Self-Help (CBTgsh). It was predicted that there would be stronger de-coupling effects in ICAT-BED compared to CBTgsh given the focus on emotion regulation skills in ICAT-BED and that greater de-coupling would predict outcomes.
Adults with BED were randomized to ICAT-BED or CBTgsh and completed 1-week EMA protocols and the Eating Disorder Examination (EDE) at pre-treatment, end-of-treatment, and 6-month follow-up (final N = 78). De-coupling was operationalized as a change in momentary associations between negative affect and binge-eating symptoms from pre-treatment to end-of-treatment.
There was a significant de-coupling effect at follow-up but not end-of-treatment, and de-coupling did not differ between ICAT-BED and CBTgsh. Less de-coupling was associated with higher end-of-treatment EDE global scores at end-of-treatment and higher binge frequency at follow-up.
Both ICAT-BED and CBTgsh were associated with de-coupling of momentary negative affect and binge-eating symptoms, which in turn relate to cognitive and behavioral treatment outcomes. Future research is warranted to identify differential mechanisms of change across ICAT-BED and CBTgsh. Results also highlight the importance of developing momentary interventions to more effectively de-couple negative affect and binge eating.
There is evidence that, besides limbic brain structures, prefrontal and insular cortical activations and deactivations are involved in the pathophysiology of panic disorder.
Objectives and aims
Using fMRI, this study investigated BOLD response patterns to stimulation with individually selected panic-specific pictures in patients with panic disorder with agoraphobia (PDA) and healthy controls. Structures of interest were the prefrontal, cingulate, and insular cortex, and the amygdalo-hippocampal complex.
21 PDA subjects (12 female, 9 male) and 21 matched controls were investigated using a Siemens 3 T scanner. Before, PDA subjects gave ratings on 120 pictures showing characteristic panic/agoraphobia situations (PA). 20 pictures with the individually highest ratings were selected. 20 matching pictures showing aversive but not panic-specific stimuli (A) and 80 neutral pictures (N) from the International Affective Picture-System (IAPS) were chosen for each subject. Anxiety and depression ratings were recorded.
Group comparisons revealed a significantly greater BOLD response in PDA subjects than in controls in the insular cortices, left inferior frontal gyrus, dmPFC, the left hippocampal formation, and left caudatum (p < .005), when PA and N responses were compared. Group comparisons for stimulation with A compared to PA showed activation of similar brain regions in both groups but with different peak coordinates.
Results indicate specific activation patterns to panic-specific picture stimulation in PDA patients. Distinct peak coordinates between PA and A differ between groups. This might implicate that the brain circuits underlying processing of aversive stimuli might differ in their function in PDA patients compared to healthy subjects.
Chronic social isolation in the elderly may be related with diverse psychiatric disorders: chronic depressive episode, paranoia-type personality, and late non-schizophrenic psychosis.
In order to separate psychotic depression and non-schizophrenic psychosis with depressive mood, there is a need for more clearly defined criteria.
We report the case of a 68 yrs. women living alone at home for more than twenty years, with a complete social isolation for two years. This behaviour was found associated with severe delusion: she unreasonably felt persecuted by her flat's owner and she dissimulated an extensive basocellular carcinoma on her face threatening her life. A history of a short depressive episode at the time of her divorce was only found, as she demonstrated at initial assessment many paranoia personality traits. A review of literature on this disorders’ association was therefore undertaken.
Evolution after admission revealed the lack of effectiveness of antipsychotic treatment on delusion, but some efficiency of antidepressant. Nevertheless, personality traits remained unaffected by care. Literature on the association between mood disorders and non-schizophrenic psychosis is rare, and we suggest some criteria that may account for psychotic depression and be useful to treatment choice.
In the absence of a history of chronic mood or psychotic disorder, it is hypothesised that paranoia symptoms may account more for a psychotic depression than for late paranoid schizophrenia. This may have consequences for therapeutic strategy.
Gene × environment (G × E) interactions in eating pathology have been increasingly investigated, however studies have been limited by sample size due to the difficulty of obtaining genetic data.
To synthesize existing G × E research in the eating disorders (ED) field and provide a clear picture of the current state of knowledge with analyses of larger samples.
Complete data from seven studies investigating community (n = 1750, 64.5% female) and clinical (n = 426, 100% female) populations, identified via systematic review, were included. Data were combined to perform five analyses: 5-HTTLPR × Traumatic Life Events (0–17 events) to predict ED status (n = 909), 5-HTTLPR × Sexual and Physical Abuse (n = 1097) to predict bulimic symptoms, 5-HTLPR × Depression to predict bulimic symptoms (n = 1256), and 5-HTTLPR × Impulsivity to predict disordered eating (n = 1149).
The low function (s) allele of 5-HTTLPR interacted with number of traumatic life events (P < .01) and sexual and physical abuse (P < .05) to predict increased likelihood of an ED in females but not males (Fig. 1). No other G × E interactions were significant, possibly due to the medium to low compatibility between datasets (Fig. 1).
Early promising results suggest that increased knowledge of G × E interactions could be achieved if studies increased uniformity of measuring ED and environmental variables, allowing for continued collaboration to overcome the restrictions of obtaining genetic samples.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI) are the most frequently used observer-rated and self-report scales of depression, respectively. It is important to know what a given total score or a change score from baseline on one scale means in relation to the other scale.
We obtained individual participant data from the randomised controlled trials of psychological and pharmacological treatments for major depressive disorders. We then identified corresponding scores of the HAMD and the BDI (369 patients from seven trials) or the BDI-II (683 patients from another seven trials) using the equipercentile linking method.
The HAMD total scores of 10, 20 and 30 corresponded approximately with the BDI scores of 10, 27 and 42 or with the BDI-II scores of 13, 32 and 50. The HAMD change scores of −20 and −10 with the BDI of −29 and −15 and with the BDI-II of −35 and −16.
The results can help clinicians interpret the HAMD or BDI scores of their patients in a more versatile manner and also help clinicians and researchers evaluate such scores reported in the literature or the database, when scores on only one of these scales are provided. We present a conversion table for future research.
We present ALMA band 7 data of the extreme OH/IR star, OH 26.5+0.6. In addition to lines of CO and its isotopologues, the circumstellar envelope also exhibits a number of emission lines due to metal-containing molecules, e.g., NaCl and KCl. A lack of C18O is expected, but a non-detection of C17O is puzzling given the strengths of H217O in Herschel spectra of the star. However, a line associated with Si17O is detected. We also report a tentative detection of a gas-phase emission line of MgS. The ALMA spectrum of this object reveals intriguing features which may be used to investigate chemical processes and dust formation during a high mass-loss phase.
Since 2013, we are performing with the Nancay Radio Telescope (NRT) a monitoring program of > 100 Galactic disk OH/IR stars, having bright 1612-MHz OH maser emission. The variations of the maser emission are used to probe the underlying stellar variability. We wish to understand how the large-amplitude variations are lost during the AGB – post-AGB transition. The fading out of pulsations with steadily declining amplitudes seems to be a viable process.
This paper examines the marine reservoir effect for Tomales Bay, a 25.5-km-long tidal estuary along the northern coast of California. We determined the regional ∆R through radiocarbon (14C) measurements of pre-1950 shells from a museum collection as well as archaeologically recovered shell samples from a historical railroad grade of known construction date. These results are compared against four sets of paired shell and bone samples from two local archaeological sites. Our results indicate little spatial variation along the inner bay, but the proposed ∆R value is lower than those previously reported for nearby areas along the Pacific Coast. We also note potential variability in regional ∆R of approximately 200 14C years for the late Holocene, and comparison with an older paired bone and shell sample points toward more significant temporal variation earlier in time.
We are currently performing a monitoring program of the 1612 MHz OH maser emission of several dozen Galactic disk OH/IR stars with the Nancay Radio Telescope (NRT). They are complemented by several OH/IR stars toward the Galactic center, which were monitored with the Hartebeesthoek radio telescope. We use the maser variations to probe the underlying stellar variability. As early monitoring programs already have shown, some stars are large amplitude variables with periods up to 7 years, others show small or even no amplitude variations. This dichotomy in the variability behaviour is assumed to mark the border between the AGB and the post-AGB stages. With the current program, we wish to find objects in transition and to describe their variability properties. We consider the fading out of pulsations with steadily declining amplitudes as a viable process. Promising candidates in the disk are the small-amplitude variables OH 138.0+7.2 and OH 51.8−0.2. ’Non-variable’ OH/IR stars in the Galactic center region may be as frequent as in the disk.
We introduce the newly developed database of circumstellar maser sources. Until now, the compilations comprehensively including the three major maser species in evolved stars (i.e., SiO, H2O, OH) has been practically limited only to the Benson’s catalog (Benson et al. 1990), which was published more than a quarter of a century ago. For OH masers alone, there exists the University of Hamburg (UH) database, but there is no updated compilation work for H2O and SiO masers. In order to utilize the information of masers in actual studies, it is highly desirable to have a database containing all the three masers. We are currently constructing a database covering SiO, H2O and OH masers. This database consists of a web-service, which accesses compiled maser observations in available archives and combines them with the data we newly collected and IR databases. The archives currently used are the OH maser archive from Engels & Bunzel (2015), and H2O and SiO archives, which are currently under construction. So far, the information of about 27,000 observations (about 10,000 objects) has been implemented. We also have a plan to extend the database by including higher transitions and other types of objects, such as young stellar objects, in future. In this paper, we briefly summarize, (1) outline of the data collected, and (2) future development plans of the eDAMS system. The URL of the database is as follows: http://maserdb.ins.urfu.ru/
The first mastotermitid termite from Africa is described and figured from wing fragments recovered from the early Miocene (22–21 Ma) deposits of the Mush Valley, Amhara Region, central Ethiopia. Mastotermes aethiopicus new species is the second fossil termite recorded from Africa and expands the known paleo-distribution of the genus from tropical North America and Europe into northeastern Africa during the Miocene. Mastotermes aethiopicus is distinguished from the living M. darwiniensis Froggatt and other Neogene species of the genus, and comments are provided regarding the occurrence of this genus in the tropical fauna of Miocene Ethiopia.
Deflection missions to near-Earth asteroids will encounter non-negligible uncertainties in the physical and orbital parameters of the target object. In order to reliably assess future impact threat mitigation operations such uncertainties have to be quantified and incorporated into the mission design. The implementation of deflection demonstration missions offers the great opportunity to test our current understanding of deflection relevant uncertainties and their consequences, e.g., regarding kinetic impacts on asteroid surfaces. In this contribution, we discuss the role of uncertainties in the NEOTωIST asteroid deflection demonstration concept, a low-cost kinetic impactor design elaborated in the framework of the NEOShield project. The aim of NEOTωIST is to change the spin state of a known and well characterized near-Earth object, in this case the asteroid (25143) Itokawa. Fast events such as the production of the impact crater and ejecta are studied via cube-sat chasers and a flyby vehicle. Long term changes, for instance, in the asteroid's spin and orbit, can be assessed using ground based observations. We find that such a mission can indeed provide valuable constraints on mitigation relevant parameters. Furthermore, the here proposed kinetic impact scenarios can be implemented within the next two decades without threatening Earth's safety.
In this appendix we formalize many of the economic arguments used throughout this book using a unified framework. The model we present distinguishes between user fees and government transfers as sources of finance for PPPs. The model also assigns an important role to demand uncertainty.
Result 1 formalizes our claim that preferring PPPs over public provision because PPPs release public resources is wrong. In our benchmark model, the optimal contractual arrangement under public provision is equivalent, from a social welfare perspective, with the optimal PPP contract. Result 2 shows how to implement the optimal infrastructure contract, both under conventional provision and under a PPP. Result 3 shows that, when the benchmark model is extended to incorporate the costs of disbursing public funds, PPPs are better than conventional provision and a PVR auction implements the contract. Results 4 and 5 establish the optimality of PPP contracts over conventional provision when we extend the benchmark model to incorporate moral hazard. These results combine the arguments in favor of PPPs from the “bundling” and “property rights” literatures. A PVR auction also implements the optimal contract. Result 6 shows that in the extension with moral hazard, higher financing costs under PPPs are socially desirable because they provide incentives for innovation.
The type of infrastructure for which PPPs have been used most – in Europe, developing countries, and the United States – is highways. In this chapter we answer the questions of when and how PPPs are appropriate for this particular kind of infrastructure.
Ideally, the best organizational form – whether traditional, PPP, or privatization – for providing a specific infrastructure should be determined by the project’s physical and economic characteristics. If political economy considerations are important – for example, opposition to privatization or to paying user fees – then the choice should reflect the interplay between these considerations and the technological and economic attributes of the infrastructure. What are the physical, technological, and economic characteristics of highways that determine whether they should be provided using public provision, PPPs, or privatization?
Physical and Economic Characteristics
Highway investments are large, sunk upfront, and long-lived. Interurban highways tend to be natural monopolies, while urban highways are usually part of a network. It follows that public intervention is justii ed, either to regulate tolls or to coordinate network planning and to oversee the intensive use of public space and rights-of-way. h is typically rules out privatization, so that the choice for most highways is between a PPP and traditional provision.
This book seeks to answer three questions: When are PPPs the best way to provide and finance infrastructure? How should PPP contracts be designed? What is the appropriate governance structure for PPPs? The answers depend on the type of infrastructure facility and on the institutional conditions in the country (or municipality, state, or province) in question. Nevertheless, several guiding principles emerge from the material we have covered in this book. In this final chapter we take stock of the various issues and speculate about the future of public-private partnerships.
In this book, we have defined a PPP as an arrangement by which a private firm (the concessionaire, usually a special purpose vehicle or SPV) sinks a substantial upfront investment to build, revamp, or acquire an existing infrastructure facility that provides services to the public. As repayment for the capital, maintenance, and operating costs, the firm receives user fee revenues, government transfers, or a combination of both during the life of a long-term contract. At the end of the concession the facility is returned to the state.