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Cold-water coral reefs are biodiversity hotspots of the deep sea. The most dominant reef-building cold-water coral in the Atlantic is Lophelia pertusa, which builds vast and structurally complex habitats. Studying the behaviours of deep-sea species is challenging due to the technological difficulties in making prolonged observations in situ, so little is known about the behavioural ecology of this important species. Observations in laboratory studies can help to enhance our understanding of the range of behaviours these species exhibit. Here we present video evidence that the cold-water coral Lophelia pertusa is capable of producing mucus nets as part of their feeding strategy. This finding suggests that L. pertusa has a more diverse range of feeding strategies than previously thought.
Whereas genetic susceptibility increases the risk for major depressive disorder (MDD), non-genetic protective factors may mitigate this risk. In a large-scale prospective study of US Army soldiers, we examined whether trait resilience and/or unit cohesion could protect against the onset of MDD following combat deployment, even in soldiers at high polygenic risk.
Data were analyzed from 3079 soldiers of European ancestry assessed before and after their deployment to Afghanistan. Incident MDD was defined as no MDD episode at pre-deployment, followed by a MDD episode following deployment. Polygenic risk scores were constructed from a large-scale genome-wide association study of major depression. We first examined the main effects of the MDD PRS and each protective factor on incident MDD. We then tested the effects of each protective factor on incident MDD across strata of polygenic risk.
Polygenic risk showed a dose–response relationship to depression, such that soldiers at high polygenic risk had greatest odds for incident MDD. Both unit cohesion and trait resilience were prospectively associated with reduced risk for incident MDD. Notably, the protective effect of unit cohesion persisted even in soldiers at highest polygenic risk.
Polygenic risk was associated with new-onset MDD in deployed soldiers. However, unit cohesion – an index of perceived support and morale – was protective against incident MDD even among those at highest genetic risk, and may represent a potent target for promoting resilience in vulnerable soldiers. Findings illustrate the value of combining genomic and environmental data in a prospective design to identify robust protective factors for mental health.
The use of transdiagnostic mental health treatments in low resource settings has been proposed as a possible aid in scaling up mental health services. Modular, multi-problem transdiagnostic treatments can be used to treat a range of mental health problems and are designed to handle comorbidity. Two randomized controlled trials have been completed on one treatment – the Common Elements Treatment Approach, or CETA – delivered by lay counsellors in Iraq and Thailand. This paper utilizes data from two clinical trials to explore the delivery of CETA by lay providers, examining fidelity and flexibility of element use. Data were collected at every therapy session. Clients completed a short symptom assessment and providers described the clinical elements delivered during sessions. Analyses included descriptive statistics of delivery including selection and sequencing of treatment elements, and the variance in element dose, clustering at the counsellor level, using multi-level models. Results indicate that lay providers in low resource settings (with supervision) demonstrated fidelity to the recommended CETA elements, order and dose, and occasionally added in elements and flexed dosage based on client presentation (i.e. flexibility). This modular approach did not result in significantly longer treatment duration. Our analysis suggests that lay providers were able to learn decision-making processes of CETA based on client presentation and adjust treatment as needed with supervision. As modular multi-problem transdiagnostic treatments continue to be explored in low resource settings, research should continue to focus on ‘unpacking’ lay counsellor delivery of these interventions, decision-making processes, and the level of supervision required.
The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment.
This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene–Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions.
A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions.
Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.
Alcohol use is commonly initiated during adolescence, with earlier onset known to increase the risk for alcohol use disorder (AUD). Altered function in neural reward circuitry is thought to increase the risk for AUD. To test the hypothesis that adolescent alcohol misuse primes the brain for alcohol-related psychopathology in early adulthood, we examined whether adolescent alcohol consumption rates predicted reward responsivity in the ventral striatum (VS), and in turn, AUD symptoms in adulthood.
A total of 139 low income, racially diverse urban males reported on their alcohol use at ages 11, 12, 15, and 17; completed self-reports of personality, psychiatric interviews, and a functional magnetic resonance imaging (fMRI) scan at age 20; and completed a psychiatric interview at age 22. We measured adolescent alcohol use trajectories using latent growth curve modeling and measured neural responses to monetary reward using a VS region of interest. We tested indirect effects of adolescent alcohol use on AUD symptoms at age 22 via VS reward-related reactivity at age 20.
Greater acceleration in adolescent alcohol use predicted increased VS response during reward anticipation at age 20. VS reactivity to reward anticipation at age 20 predicted AUD symptoms at age 22, over and above concurrent symptoms. Accelerated adolescent alcohol use predicted AUD symptoms in early adulthood via greater VS reactivity to reward anticipation.
Prospective findings support a pathway through which adolescent alcohol use increases the risk for AUD in early adulthood by impacting reward-related neural functioning. These results highlight increased VS reward-related reactivity as a biomarker for AUD vulnerability.
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
Three arguments are advanced from human and nonhuman primate infancy research for the exaptation of ingestive mouth movements (tongue protrusion and lip smacking) for the purposes of social communication: their relation to affiliative behaviours, their sensitivity to social context, and their role in social development. Although these behaviours may have an aerodigestive function, such an account of their occurrence is only partial.
Investigations of drinking behavior across military deployment cycles are scarce, and few prospective studies have examined risk factors for post-deployment alcohol misuse.
Prevalence of alcohol misuse was estimated among 4645 US Army soldiers who participated in a longitudinal survey. Assessment occurred 1–2 months before soldiers deployed to Afghanistan in 2012 (T0), upon their return to the USA (T1), 3 months later (T2), and 9 months later (T3). Weights-adjusted logistic regression was used to evaluate associations of hypothesized risk factors with post-deployment incidence and persistence of heavy drinking (HD) (consuming 5 + alcoholic drinks at least 1–2×/week) and alcohol or substance use disorder (AUD/SUD).
Prevalence of past-month HD at T0, T2, and T3 was 23.3% (s.e. = 0.7%), 26.1% (s.e. = 0.8%), and 22.3% (s.e. = 0.7%); corresponding estimates for any binge drinking (BD) were 52.5% (s.e. = 1.0%), 52.5% (s.e. = 1.0%), and 41.3% (s.e. = 0.9%). Greater personal life stress during deployment (e.g., relationship, family, or financial problems) – but not combat stress – was associated with new onset of HD at T2 [per standard score increase: adjusted odds ratio (AOR) = 1.20, 95% CI 1.06–1.35, p = 0.003]; incidence of AUD/SUD at T2 (AOR = 1.54, 95% CI 1.25–1.89, p < 0.0005); and persistence of AUD/SUD at T2 and T3 (AOR = 1.30, 95% CI 1.08–1.56, p = 0.005). Any BD pre-deployment was associated with post-deployment onset of HD (AOR = 3.21, 95% CI 2.57–4.02, p < 0.0005) and AUD/SUD (AOR = 1.85, 95% CI 1.27–2.70, p = 0.001).
Alcohol misuse is common during the months preceding and following deployment. Timely intervention aimed at alleviating/managing personal stressors or curbing risky drinking might reduce risk of alcohol-related problems post-deployment.
High-quality cost estimates for hospital-acquired Clostridium difficile infection (CDI) are vital evidence for healthcare policy and decision-making.
To evaluate the costs attributable to hospital-acquired CDI from the healthcare payer perspective.
We conducted a population-based propensity-score matched cohort study of incident hospitalized subjects diagnosed with CDI (those with the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada code A04.7) from January 1, 2003, through December 31, 2010, in Ontario, Canada. Infected subjects were matched to uninfected subjects (those without the code A04.7) on age, sex, comorbidities, geography, and other variables, and followed up through December 31, 2011. We stratified results by elective and nonelective admissions. The main study outcomes were up-to-3-year costs, which were evaluated in 2014 Canadian dollars.
We identified 28,308 infected subjects (mean annual incidence, 27.9 per 100,000 population, 3.3 per 1,000 admissions), with a mean age of 71.5 years (range, 0–107 years), 54.0% female, and 8.0% elective admissions. For elective admission subjects, cumulative mean attributable 1-, 2-, and 3-year costs adjusted for survival (undiscounted) were $32,151 (95% CI, $28,192–$36,005), $34,843 ($29,298–$40,027), and $37,171 ($30,364–$43,415), respectively. For nonelective admission subjects, the corresponding costs were $21,909 ($21,221–$22,609), $26,074 ($25,180–$27,014), and $29,944 ($28,873–$31,086), respectively.
Hospital-acquired CDI is associated with substantial healthcare costs. To the best of our knowledge, this study is the first CDI costing study to present longitudinal costs. New strategies may be warranted to mitigate this costly infectious disease.
Anxious mothers' parenting, particularly transfer of threat information, has been considered important in their children's risk for social anxiety disorder (SAnxD), and maternal narratives concerning potential social threat could elucidate this contribution. Maternal narratives to their preschool 4- to 5-year-old children, via a picture book about starting school, were assessed in socially anxious (N = 73), and nonanxious (N = 63) mothers. Child representations of school were assessed via doll play (DP). After one school term, mothers (Child Behavior Checklist [CBCL]) and teachers (Teacher Report Form) reported on child internalizing problems, and child SAnxD was assessed via maternal interview. Relations between these variables, infant behavioral inhibition, and attachment, were examined. Socially anxious mothers showed more negative (higher threat attribution) and less supportive (lower encouragement) narratives than controls, and their children's DP representations SAnxD and CBCL scores were more adverse. High narrative threat predicted child SAnxD; lower encouragement predicted negative child CBCL scores and, particularly for behaviorally inhibited children, Teacher Report Form scores and DP representations. In securely attached children, CBCL scores and risk for SAnxD were affected by maternal anxiety and threat attributions, respectively. Low encouragement mediated the effects of maternal anxiety on child DP representations and CBCL scores. Maternal narratives are affected by social anxiety and contribute to adverse child outcome.
The movement of fluids through a porous medium is a function of the material type and the size and morphology of the voids. In the conservation of painted artworks, the movement of materials (for example, cleaning solutions) is a major factor in how a work reacts to treatments and a large influence on how the work will change with time. Of particular importance in the conservation of painted surfaces is the preparatory layer. This is a highly active transport medium because it is generally highly porous and a comparatively large and uniform component of a painted surface. In this work, a gesso film of calcium carbonate and rabbit skin glue, typical of the preparatory layer of many painted works, and an acrylic-based gesso film were imaged by focused ion beam (FIB) scanning. The gessoes were milled and scanned with gallium ions serially, in sequential planes orthogonal to the plane of the film. This yielded quantifiable measurements of the fine internal structures at a resolution far higher than previously reported for this type of material. This enabled a greater understanding of the geometry of the internal surfaces, increasing the understanding of the mechanics of capillary flow and diffusive behavior in this extremely common and significant material.
Gessoes are widely used in easel painting as grounds or preparatory layers; in art conservation, gessoes are employed as infill materials to level a loss in the paint surface in preparation for inpainting. The goal of this investigation was to establish the relationship between the mechanical behavior of various gessoes when exposed to different relative humidities (25%, 50%, and 100%) and to compare modern commercial gesso products with a traditional gesso. The materials included two commercial artists’ acrylic gessoes (composed of largely titanium dioxide and aqueous dispersions of acrylic polymers), two commercial spackling compounds frequently used in the conservation of easel paintings, and a traditional gesso (calcium carbonate and rabbit skin glue). Uniaxial tensile testing was used to characterize the elastic modulus, strain at failure, and ultimate tensile strength (UTS) of the materials. By understanding the physical limits of these materials under different conditions, damage to artworks and the failure of conservation treatments containing these types of materials may be prevented or reduced.
The bully/victim relationship was studied in a sample of elementary school children (N = 1,289 in first, third, and fifth grades). Three questions were tested. Does bullying involve a power differential between bully and victim? Are bully/victim dyads participants in a relationship, whether mutual liking or disliking? Does the gender composition of the bully/victim dyad moderate power differential and relational context patterns? Hierarchical linear modeling was used to analyze predictors of the reputational strength of bully/victim ties. The findings revealed that the bully/victim dyads most frequently nominated by peers were characterized by asymmetries in social status, where bullies were increasingly more popular than their victims, and by asymmetries in aggression, where bullies were increasingly less aggressive than their victims. Bullies and victims were likely to select one another as among the children that they least like. Most effects with respect to aggression, popularity, and relationships were moderated by the gender composition of the bully/victim dyad. Implications for a developmental psychopathology perspective on peer bullying and victimization are highlighted.
This study examined whether parents’ social information processing was related to their subsequent reports of their harsh discipline. Interviews were conducted with mothers (n = 1,277) and fathers (n = 1,030) of children in 1,297 families in nine countries (China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States), initially when children were 7 to 9 years old and again 1 year later. Structural equation models showed that parents’ positive evaluations of aggressive responses to hypothetical childrearing vignettes at Time 1 predicted parents’ self-reported harsh physical and nonphysical discipline at Time 2. This link was consistent across mothers and fathers, and across the nine countries, providing support for the universality of the link between positive evaluations of harsh discipline and parents’ aggressive behavior toward children. The results suggest that international efforts to eliminate violence toward children could target parents’ beliefs about the acceptability and advisability of using harsh physical and nonphysical forms of discipline.
Introduction: Not enough smokers access existing stop smoking services (SSS). Developing more accessible and effective SSS is important, particularly for smokers from socioeconomically disadvantaged groups where smoking is more prevalent.
Aims: To consider smokers’ reasons for accessing a community-based mobile SSS (MSSS) for initial and follow-up consultations, and to explore their experiences of the service over time.
Methods: The MSSS was delivered in socioeconomically disadvantaged areas of Nottingham (UK). Thirty-six smokers were interviewed, and 11 of these also completed follow-up interviews four to six weeks after their quit date. Interviews were analysed using the framework approach.
Results: Many participants had considered quitting before they had knowledge of the MSSS. Features of the MSSS participants found appealing for both initial and follow-up consultations included the drop-in format, convenient times and locations that fit around their existing routines, and that the service was informal and held in a non-health setting. Participants found visiting standard SSS, particularly clinics held in health settings, stressful and formal resulting in them feeling uncomfortable discussing smoking in these settings.
Conclusions: Developing instantly accessible and convenient SSS that can be delivered in familiar and informal settings within smokers’ communities may facilitate access and help to retain service users over time.
Some data suggest that older adults with anxiety disorders do not respond as well to treatment as do younger adults.
We examined age differences in outcomes from the Coordinated Anxiety Learning and Management (CALM) study, an effectiveness trial comparing usual care to a computer-assisted collaborative care intervention for primary care patients with panic disorder, generalised anxiety disorder, post-traumatic stress disorder (PTSD), and/or social anxiety disorder. This is the first study to examine the efficacy of a collaborative care intervention in a sample that included both younger and older adults with anxiety disorders. We hypothesised that older adults would show a poorer response to the intervention than younger adults.
We examined findings for the overall sample, as well as within each diagnostic category (clinicaltrials.gov identifier: NCT00347269).
The CALM intervention was more effective than usual care among younger adults overall and for those with generalised anxiety disorder, panic disorder and social anxiety disorder. Among older adults, the intervention was effective overall and for those with social anxiety disorder and PTSD but not for those with panic disorder or generalised anxiety disorder. The effects of the intervention also appeared to erode by the 18-month follow-up, and there were no significant effects on remission among the older adults.
These results are consistent with the findings of other investigators suggesting that medications and psychotherapy for anxiety disorders may not be as effective for older individuals as they are for younger people.