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Alcohol use disorder (AUD) is common and associated with increased risk of suicide.
To examine healthcare utilisation prior to suicide in persons with AUD in a large population-based cohort, which may reveal opportunities for prevention.
A national cohort study was conducted of 6 947 191 adults in Sweden in 2002, including 256 647 (3.7%) with AUD, with follow-up for suicide through 2015. A nested case–control design examined healthcare utilisation among people with AUD who died by suicide and 10:1 age- and gender-matched controls.
In 86.7 million person-years of follow-up, 15 662 (0.2%) persons died by suicide, including 2601 (1.0%) with AUD. Unadjusted and adjusted relative risks for suicide associated with AUD were 8.15 (95% CI 7.86–8.46) and 2.22 (95% CI 2.11–2.34). Of the people with AUD who died by suicide, 39.7% and 75.6% had a healthcare encounter <2 weeks or <3 months before the index date respectively, compared with 6.3% and 25.4% of controls (adjusted prevalence ratio (PR) and difference (PD), <2 weeks: PR = 3.86, 95% CI 3.50–4.25, PD = 26.4, 95% CI 24.2–28.6; <3 months: PR = 2.03, 95% CI 1.94–2.12, PD = 34.9, 95% CI 32.6–37.1). AUD accounted for more healthcare encounters within 2 weeks of suicide among men than women (P = 0.01). Of last encounters, 48.1% were in primary care and 28.9% were in specialty out-patient clinics, mostly for non-psychiatric diagnoses.
Suicide among persons with AUD is often shortly preceded by healthcare encounters in primary care or specialty out-patient clinics. Encounters in these settings are important opportunities to identify active suicidality and intervene accordingly in patients with AUD.
This study examined a potential lexicality advantage in young children's early speech production: do children produce sound sequences less accurately in nonwords than real words? Children aged 3;3-4;4 completed two tasks: a real word repetition task and a corresponding nonword repetition task. Each of the 23 real words had a paired consonant-vowel sequence in the nonword in word-initial position (e.g., ‘su’ in [ˈsutkes] ‘suitcase’ and [ˈsudrɑs]). The word-initial consonant-vowel sequences were kept constant between the paired words. Previous work on this topic compared different sequences of paired sounds, making it hard to determine if those results were due to a lexical or phonetic effect. Our results show that children reliably produced consonant-vowel sequences in real words more accurately than nonwords. The effect was most pronounced in children with smaller receptive vocabularies. Together, these results reinforce theories arguing for interactions between vocabulary size and phonology in language development.
This study investigated whether individual differences in receptive vocabulary, speech perception and production, and nonword repetition at age 2 years, 4 months to 3 years, 4 months predicted phonological awareness 2 years later. One hundred twenty-one children were tested twice. During the first testing period (Time 1), children’s receptive vocabulary, speech perception and production, and nonword repetition were measured. Nonword repetition accuracy in the present study was distinct from other widely used measures of nonword repetition in that it focused on narrow transcription of diphone sequences in each nonword that differed systematically in phonotactic probability. At the second testing period (Time 2), children’s phonological awareness was measured. The best predictors of phonological awareness were a measure of speech production and a measure of phonological processing derived from performance on the nonword repetition task. The results of this study suggest that nonword repetition accuracy provides an implicit measure of phonological skills that are indicative of later phonological awareness at an age when children are too young to perform explicit phonological awareness tasks reliably.
Can drug abuse (DA) be transmitted psychologically between adult siblings consistent with a social contagion model?
We followed Swedish sibling pairs born in 1932–1990 until one of them, sibling1 (S1), had a first DA registration. We then examined, using Cox regression, the hazard rate for a first registration for DA in sibling2 (S2) within 3 years of a first DA registration in S1 as a function of their geographical proximity. We examined 153 294 informative pairs. To control for familial confounding, we repeated these analyses in sibships containing multiple pairs, comparing risk in different siblings with their proximity to S1. DA was recorded in medical, criminal or pharmacy registries.
The best-fit model predicted risk for DA in S2 as a function of the log of kilometres between S1 and S2 with parameter estimates (±95% confidence intervals) of 0.94 (0.92; 0.95). Prediction of DA included effects of cohabitation and an interaction of proximity and time since S1 registration with stronger effects of proximity early in the follow-up period. Proximity effects were stronger for smaller S1–S2 age differences and for same- v. opposite-sex pairs. Sibship analyses confirmed sibling-pair results.
Consistent with a social contagion model, the probability of transmission of a first registration for DA in sibling pairs is related to their geographical proximity and similarity in age and sex. Such effects for DA are time-dependent and include cohabitation effects. These results illustrate the complexity of the familial aggregation of DA and support efforts to reduce their contagious spread within families in adulthood.
Although there is ample evidence that stock markets react negatively to unethical corporate behavior, our understanding of the mechanisms that shape variation in these reactions across different incidents of misconduct remains underdeveloped. We propose and test a framework for explaining this variation by focusing on the role of the media in disseminating initial information about misconduct. We argue that the signaling effects of this information are important for investors because corporations have strong incentives to limit the information they disclose about misconduct. More specifically, we hypothesize that investors are more likely to react negatively when the media presents clear and credible information that misconduct occurred, that the firm was responsible for it, and that the misconduct was the result of deeper organizational problems. We also predict that information which signals that a firm has restorative capacity tempers investor reactions when the media places blame for misconduct on the corporation rather than specific individuals. We test our hypotheses in a unique sample of 345 acts of corporate misconduct in five European countries. Our findings provide broad support for our hypotheses, and we discuss implications for research on corporate misconduct and the role of non-state actors in regulating unethical corporate behavior.
Major efforts are being undertaken to quantify seismic hazard and risk due to production-induced earthquakes in the Groningen gas field as the basis for rational decision-making about mitigation measures. An essential element is a model to estimate surface ground motions expected at any location for each earthquake originating within the gas reservoir. Taking advantage of the excellent geological and geophysical characterisation of the field and a growing database of ground-motion recordings, models have been developed for predicting response spectral accelerations, peak ground velocity and ground-motion durations for a wide range of magnitudes. The models reflect the unique source and travel path characteristics of the Groningen earthquakes, and account for the inevitable uncertainty in extrapolating from the small observed magnitudes to potential larger events. The predictions of ground-motion amplitudes include the effects of nonlinear site response of the relatively soft near-surface deposits throughout the field.
The relationship between the genetic and environmental risk factors for alcohol use disorders (AUD) detected in Swedish medical, pharmacy, and criminal registries has not been hitherto examined. Prior twin studies have varied with regard to the detection of shared environmental effects and sex differences in the etiology of AUD. In this report, structural equation modeling in OpenMx was applied to (1) the three types of alcohol registration in a population-based sample of male–male twins and reared-together full and half siblings (total 208,810 pairs), and (2) AUD, as a single diagnosis, in male–male, female–female, and opposite-sex (OS) twins and reared-together full and half siblings (total 787,916 pairs). An independent pathway model fit best to the three forms of registration and indicated that between 70% and 92% of the genetic and 63% and 98% of the shared environmental effects were shared in common with the remainder unique to each form of AUD registration. Criminal registration had the largest proportion of unique genetic and environmental factors. The best fit model for AUD estimated the heritability to be 22% and 57%, respectively, in females and males. Both shared (12% vs. 6%) and special twin environment (29% vs. 2%) were substantially more important in females versus males. In conclusion, AUD ascertained from medical, pharmacy, and criminal Swedish registries largely share the same genetic and environmental risk factors. Large sex differences in the etiology of AUD were seen in this sample, with substantially stronger familial environmental and weaker genetic effects in females versus males.
Recognizing familiar words quickly and accurately facilitates learning new words, as well as other aspects of language acquisition. This study used the visual world paradigm with semantic and phonological competitors to study lexical processing efficiency in 2- to 5-year-old children. Experiment 1 found this paradigm was sensitive to vocabulary-size differences. Experiment 2 included a more diverse group of children who were tested in their native dialect (either African American English or mainstream American English). No effect of stimulus dialect was observed. The results showed that vocabulary size was a better predictor of eye gaze patterns than was maternal education, but that maternal education level had a moderating effect; as maternal education level increased, vocabulary size was less predictive of lexical processing efficiency.
About 20% of major depressive episodes become chronic and medication-refractory and also appear to be less responsive to standard cognitive–behavioural therapy (CBT).
To test whether CBT developed from behavioural activation principles that explicitly and exclusively targets depressive rumination enhances treatment as usual (TAU) in reducing residual depression.
Forty-two consecutively recruited participants meeting criteria for medication-refractory residual depression were randomly allocated to TAU v. TAU plus up to 12 sessions of individual rumination-focused CBT. The trial has been registered (ISRCTN22782150).
Adding rumination-focused CBT to TAU significantly improved residual symptoms and remission rates. Treatment effects were mediated by change in rumination.
This is the first randomised controlled trial providing evidence of benefits of rumination-focused CBT in persistent depression. Although suggesting the internal validity of rumination-focused CBT for residual depression, the trial lacked an attentional control group so cannot test whether the effects were as a result of the specific content of rumination-focused CBT v. non-specific therapy effects.