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  • Obsessive–compulsive disorder (OCD) is associated with increased engagement of frontal brain regions across multiple event-related potentials
  • M. Prabhavi N. Perera, Sudaraka Mallawaarachchi, Neil W. Bailey, Oscar W. Murphy, Paul B. Fitzgerald
  • Journal: Psychological Medicine , First View
  • Published online by Cambridge University Press: 24 April 2023, pp. 1-13
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    Background

    Obsessive–compulsive disorder (OCD) is a psychiatric condition leading to significant distress and poor quality of life. Successful treatment of OCD is restricted by the limited knowledge about its pathophysiology. This study aimed to investigate the pathophysiology of OCD using electroencephalographic (EEG) event-related potentials (ERPs), elicited from multiple tasks to characterise disorder-related differences in underlying brain activity across multiple neural processes.

    Methods

    ERP data were obtained from 25 OCD patients and 27 age- and sex-matched healthy controls (HCs) by recording EEG during flanker and go/nogo tasks. Error-related negativity (ERN) was elicited by the flanker task, while N200 and P300 were generated using the go/nogo task. Primary comparisons of the neural response amplitudes and the topographical distribution of neural activity were conducted using scalp field differences across all time points and electrodes.

    Results

    Compared to HCs, the OCD group showed altered ERP distributions. Contrasting with the previous literature on ERN and N200 topographies in OCD where fronto-central negative voltages were reported, we detected positive voltages. Additionally, the P300 was found to be less negative in the frontal regions. None of these ERP findings were associated with OCD symptom severity.

    Conclusions

    These results indicate that individuals with OCD show altered frontal neural activity across multiple executive function-related processes, supporting the frontal dysfunction theory of OCD. Furthermore, due to the lack of association between altered ERPs and OCD symptom severity, they may be considered potential candidate endophenotypes for OCD.

  • Prospective associations between the nutritional quality of foods consumed (graded by the FSAm-NPS underlying the Nutri-Score) and mortality in Europe
  • Mélanie Deschasaux, Inge Huybrechts, Neil Murphy, Chantal Julia, Serge Hercberg, Bernard Srour, Emmanuelle Kesse-Guyot, Paule Latino-Martel, Carine Biessy, Corinne Casagrande, Mazda Jenab, Heather Ward, Elisabete Weiderpass, Pietro Ferrari, Elio Riboli, Marc Gunter, Mathilde Touvier
  • Journal: Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
  • Published online by Cambridge University Press: 10 June 2020, E129
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    In 2017, 11 million deaths related to non-communicable diseases (NCDs) were attributable to dietary risk factors (GBD, 2019). Helping consumers make healthier food choices hence appears as one key strategy to prevent NCDs-related mortality. To this end, political authorities are considering implementing a simple label to reflect the nutritional quality of food products. The five-colour Nutri-Score label, derived from the Nutrient Profiling System of the British Food Standards Agency (FSAm-NPS), has been chosen by several countries in Europe (France, Belgium, Spain). Yet, its implementation is still voluntary per EU labelling regulation. Scientific evidence is therefore needed regarding the relevance of the FSAm-NPS at the European level. Following on our results showing an increased risk of cancer related to the consumption of foods with a high FSAm-NPS score in the EPIC cohort, our objective is now to focus on NCDs-related mortality. Our prospective analyses included 501,594 adults from the EPIC cohort (1992–2015, median follow-up: 17.2 years). Mortality events occurring < 2 years after recruitment were excluded, leaving 50,743 death events (main causes: cancer, n = 21,971; cerebro/cardiovascular diseases, n = 12,407; respiratory diseases, n = 2,796). Usual food intakes were assessed with standardized country-specific diet assessment methods. The FSAm-NPS was calculated for each food/beverage using their 100-g content in energy, sugar, saturated fatty acid, sodium, fibres, proteins, and fruits/vegetables/legumes/nuts. The individual FSAm-NPS Dietary Index (DI) is obtained as an energy-weighted mean of the FSAm-NPS scores of all food items usually consumed by a participant. Cox proportional hazards models adjusted for confounding factors, including personal history of cancer, cardiovascular diseases and diabetes were computed. Fine and Gray models were also tested to take into account competing events for cause-specific mortality analyses. A higher FSAm-NPS DI score, reflecting a lower nutritional quality of the diet, was associated with a higher mortality risk overall (HRQ5vs.Q1 = 1.06 [95%CI: 1.02–1.09], P-trend < 0.001) and by cancer (HRQ5vs.Q1 = 1.06 [1.01–1.11], P-trend = 0.003) and respiratory diseases (HRQ5vs.Q1 = 1.33 [1.16–1.52], P-trend < 0.001), with similar results in competing events analyses. Associations with cerebro-/cardiovascular diseases mortality were weaker (HRQ5vs.Q1 = 1.05 [0.98,1.11], P-trend = 0.04) and no longer statistically significant in competing events analyses. In this large multinational European cohort, the consumption of food products with a higher FSAm-NPS score (lower nutritional quality of the foods consumed) was associated with a higher mortality risk, supporting the relevance of the FSAm-NPS to grade the nutritional quality of food products for public health applications (e.g, Nutri-Score) aiming to guide the consumers towards healthier food choices.

  • A validation study of the International Trauma Questionnaire to assess post-traumatic stress disorder in treatment-seeking veterans
  • Part of
  • Dominic Murphy, Mark Shevlin, Emily Pearson, Neil Greenberg, Simon Wessely, Walter Busuttil, Thanos Karatzias
  • Journal: The British Journal of Psychiatry / Volume 216 / Issue 3 / March 2020
  • Published online by Cambridge University Press: 28 February 2020, pp. 132-137
  • Print publication: March 2020
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    Background

    Veterans with post-traumatic stress disorder (PTSD) typically report a poorer treatment response than those who have not served in the Armed Forces. A possible explanation is that veterans often present with complex symptoms of PTSD. ICD-11 PTSD and complex PTSD (CPTSD) have not previously been explored in a military sample.

    Aims

    This study aimed to validate the only measure of ICD-11 PTSD and CPTSD, the International Trauma Questionnaire, and assess the rates of the disorder in a sample of treatment-seeking UK veterans.

    Method

    A sample of help-seeking veterans (N = 177) was recruited from a national charity in the UK that provides clinical services to veterans. Participants completed measures of ICD-11 PTSD and CPTSD as well as childhood and adult traumatic life events. Confirmatory factor analysis was used to assess the latent structure of PTSD and CPTSD symptoms, and rates of the disorders were estimated.

    Results

    The majority of the participants (70.7%) reported symptoms consistent with a diagnosis of either PTSD or CPTSD. Results indicated the presence of two separate disorders, with CPTSD being more frequently endorsed (56.7%) than PTSD (14.0%). CPTSD was more strongly associated with childhood trauma than PTSD.

    Conclusions

    The International Trauma Questionnaire can adequately distinguish between PTSD and CPTSD within clinical samples of veterans. There is a need to explore the effectiveness of existing and new treatments for CPTSD in military personnel.

  • Psychological interventions for ICD-11 complex PTSD symptoms: systematic review and meta-analysis
  • Thanos Karatzias, Philip Murphy, Marylene Cloitre, Jonathan Bisson, Neil Roberts, Mark Shevlin, Philip Hyland, Andreas Maercker, Menachem Ben-Ezra, Peter Coventry, Susan Mason-Roberts, Aoife Bradley, Paul Hutton
  • Journal: Psychological Medicine / Volume 49 / Issue 11 / August 2019
  • Published online by Cambridge University Press: 12 March 2019, pp. 1761-1775
  • Print publication: August 2019
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    Background

    The 11th revision to the WHO International Classification of Diseases (ICD-11) identified complex post-traumatic stress disorder (CPTSD) as a new condition. There is a pressing need to identify effective CPTSD interventions.

    Methods

    We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological interventions for post-traumatic stress disorder (PTSD), where participants were likely to have clinically significant baseline levels of one or more CPTSD symptom clusters (affect dysregulation, negative self-concept and/or disturbed relationships). We searched MEDLINE, PsycINFO, EMBASE and PILOTS databases (January 2018), and examined study and outcome quality.

    Results

    Fifty-one RCTs met inclusion criteria. Cognitive behavioural therapy (CBT), exposure alone (EA) and eye movement desensitisation and reprocessing (EMDR) were superior to usual care for PTSD symptoms, with effects ranging from g = −0.90 (CBT; k = 27, 95% CI −1.11 to −0.68; moderate quality) to g = −1.26 (EMDR; k = 4, 95% CI −2.01 to −0.51; low quality). CBT and EA each had moderate–large or large effects on negative self-concept, but only one trial of EMDR provided useable data. CBT, EA and EMDR each had moderate or moderate–large effects on disturbed relationships. Few RCTs reported affect dysregulation data. The benefits of all interventions were smaller when compared with non-specific interventions (e.g. befriending). Multivariate meta-regression suggested childhood-onset trauma was associated with a poorer outcome.

    Conclusions

    The development of effective interventions for CPTSD can build upon the success of PTSD interventions. Further research should assess the benefits of flexibility in intervention selection, sequencing and delivery, based on clinical need and patient preferences.

  • 4 - The Settlement of the Boulonnais
  • Neil Murphy, Northumbria University, Newcastle
  • Book: The Tudor Occupation of Boulogne
  • Published online: 25 January 2019
  • Print publication: 07 February 2019, pp 106-169
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    Summary

    This chapter examines the manner by which Henry VIII integrated the lands he conquered in France in the 1540s into his English kingdom. Henry and his ministers sought to rebuild the Boulonnais in the image of lowland England, and they developed an agricultural policy and settlement strategy which was designed to secure English control over the region. It considers the role which cultivation played in asserting claims to territory, as well as conflicts regarding natural resources and the control of lands. It analyses in detail the workings of the special commission which implemented the Tudor monarch’s plans for the re-settlement of the Boulonnais, as well as the methods it used to encourage English settlers to take up farms in the region. It examines the means by which these lands were anglicised, considering the introduction of English laws and customs into the Boulonnais as well as the administrative systems required to enforce them. The chapter also looks more widely at the economic conditions of these lands, considering both the redevelopment of commercial life at Boulogne and the return of French peasants to the land to act as a rural labour force. The final part of the chapter examines the manner by which English forms of worship were imposed on the region as a further means to anglicise these lands.
  • 3 - Conquest, Cartography and Treaty
  • Neil Murphy, Northumbria University, Newcastle
  • Book: The Tudor Occupation of Boulogne
  • Published online: 25 January 2019
  • Print publication: 07 February 2019, pp 66-105
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    Summary

    The chapter considers Henry VIII’s strategy in France in the 1540s. It shows that he moved away from trying to assert his rule over the French population as the rightful king of France and instead annexed the lands he had conquered to his English crown. It shows that Henry’s territorial objectives shaped the terms of the peace which brought an end to the war in 1546, particularly because – rather than assert his ancestral claims to the throne of France – the Tudor monarch justified his actions by invoking the right of conquest. The final part of the chapter examines the crucial role that cartography played in the conquest of Boulogne. This was the first major English conflict where maps played a central role in both the progress of the war and the making of the peace. Indeed, the war with France in the 1540s led to developments in geometric mapping, which the English monarch used to create coherent linear borders for his new lands.
  • 5 - The Boulogne Garrison
  • Neil Murphy, Northumbria University, Newcastle
  • Book: The Tudor Occupation of Boulogne
  • Published online: 25 January 2019
  • Print publication: 07 February 2019, pp 170-229
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    Summary

    The chapter begins with an investigation of the form and composition of the councils Henry VIII set up at Boulogne and New Haven. As well as being filled by members of loyal families who had experience of service on the frontiers of the realm, these councils provided a new generation of men with their formative experiences of border warfare. The garrisons formed the backbone of English rule in the Boulonnais, and the farms and estates granted to these men gave them a personal stake in the defending the king’s lands. The chapter also looks at the development of cutting-edge fortifications in the Boulonnais in 1540s, which cost vast amounts of money to build and maintain. Despite the enormous amount of money Henry VIII poured into the defence of Boulogne, the garrisons lived in dire conditions, which posed a serious threat to Henry’s efforts to secure the defence of this region. The chapter concludes by exploring the role which soldiers from the Boulogne garrison came to play in the Protestant history of England.
  • 2 - Violence and the Campaign of 1544–1546
  • Neil Murphy, Northumbria University, Newcastle
  • Book: The Tudor Occupation of Boulogne
  • Published online: 25 January 2019
  • Print publication: 07 February 2019, pp 18-65
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    Summary

    This chapter examines the devastating impact Henry VIII's conquest had on the native population of the Boulonnais. It shows that the English employed a severe military strategy which targeted non-combatants and led to the almost total depopulation of the region. The native inhabitants of the Boulonnais were represented as a hostile and rebellious people, which, according to the contemporary laws of war, provided the English monarch with grounds to apply harsh methods of warfare against these people. Peasants were massacred or driven from their homes as the Tudor commanders sought to clear the land of its people. English soldiers hunted down and drove out the refugee populations which had fled into woods and other remote locations. Henry’s commanders implemented a scorched-earth strategy in order to destroy the land and create a man-made famine. The final part of the chapter explores retributive violence, including reprisal attacks on English villages and the extrajudicial killing of prisoners.
  • 1 - The Conquest of Boulogne and the History of Tudor England
  • Neil Murphy, Northumbria University, Newcastle
  • Book: The Tudor Occupation of Boulogne
  • Published online: 25 January 2019
  • Print publication: 07 February 2019, pp 1-17
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    Summary

    This chapter examines how historians of Tudor England have treated Henry VIII's conquest of Boulogne and shows that if the conquest of Boulogne is mentioned at all in the histories of the king’s reign it is typically in a highly critical manner. It sets out the key arguments put forward in the book, particularly those relating to violence, imperialism, English foreign policy and the comparative history of Tudor borderlands. It also situates Henry VIII's conquest of Boulogne within in the wider context of English overseas expansion and the struggles with the Valois monarchy for the throne of France. As well as drawing comparisons with the conquest of Ireland, it compares Henry VIII’s war in France in the 1540s with his actions in Scotland during this period. It finishes with a discussion of the contemporary English, French and Imperial records which detail Henry VIII’s conquest of Boulogne, from narrative sources, such as chronicles and letters, to visual materials, such as maps and paintings.
  • 6 - The Tudor Occupation of Boulogne and English Imperialism
  • Neil Murphy, Northumbria University, Newcastle
  • Book: The Tudor Occupation of Boulogne
  • Published online: 25 January 2019
  • Print publication: 07 February 2019, pp 230-255
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    Summary

    This chapter argues that Henry VIII’s conquest of Boulogne was one of the most important events of his reign and shows the need to revise our assumptions about a number of key aspects of Tudor history in light of English actions in France in the 1540s. It shows that form of military colonisation which Henry VIII employed at Boulogne set the tone for the Tudor monarchy’s expansionist strategy in Ireland and that there were a number of connections between the two zones of conquest. It reveals that men who had served in France in the 1540s were deployed to other frontiers, leading to a diffusion of skills and practices across the kingdom. The chapter also demonstrates that the severe military methods the English employed against the Irish in the sixteenth century were not exceptional, and it emphasises the formative role that service in France and Scotland played in the wider upsurge in violence across the English monarch’s dominions during the sixteenth century. This chapter also challenges the view that England was detaching itself from continental European concerns following the break with Rome in the 1530s and shows that Henry VIII’s efforts in the 1540s were principally focused on expanding his territories in France.

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