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Definition of disorder subtypes may facilitate precision treatment for posttraumatic stress disorder (PTSD). We aimed to identify PTSD subtypes and evaluate their associations with genetic risk factors, types of stress exposures, comorbidity, and course of PTSD.
Data came from a prospective study of three U.S. Army Brigade Combat Teams that deployed to Afghanistan in 2012. Soldiers with probable PTSD (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition ≥31) at three months postdeployment comprised the sample (N = 423) for latent profile analysis using Gaussian mixture modeling and PTSD symptom ratings as indicators. PTSD profiles were compared on polygenic risk scores (derived from external genomewide association study summary statistics), experiences during deployment, comorbidity at three months postdeployment, and persistence of PTSD at nine months postdeployment.
Latent profile analysis revealed profiles characterized by prominent intrusions, avoidance, and hyperarousal (threat-reactivity profile; n = 129), anhedonia and negative affect (dysphoric profile; n = 195), and high levels of all PTSD symptoms (high-symptom profile; n = 99). The threat-reactivity profile had the most combat exposure and the least comorbidity. The dysphoric profile had the highest polygenic risk for major depression, and more personal life stress and co-occurring major depression than the threat-reactivity profile. The high-symptom profile had the highest rates of concurrent mental disorders and persistence of PTSD.
Genetic and trauma-related factors likely contribute to PTSD heterogeneity, which can be parsed into subtypes that differ in symptom expression, comorbidity, and course. Future studies should evaluate whether PTSD typology modifies treatment response and should clarify distinctions between the dysphoric profile and depressive disorders.
Unit cohesion may protect service member mental health by mitigating effects of combat exposure; however, questions remain about the origins of potential stress-buffering effects. We examined buffering effects associated with two forms of unit cohesion (peer-oriented horizontal cohesion and subordinate-leader vertical cohesion) defined as either individual-level or aggregated unit-level variables.
Longitudinal survey data from US Army soldiers who deployed to Afghanistan in 2012 were analyzed using mixed-effects regression. Models evaluated individual- and unit-level interaction effects of combat exposure and cohesion during deployment on symptoms of post-traumatic stress disorder (PTSD), depression, and suicidal ideation reported at 3 months post-deployment (model n's = 6684 to 6826). Given the small effective sample size (k = 89), the significance of unit-level interactions was evaluated at a 90% confidence level.
At the individual-level, buffering effects of horizontal cohesion were found for PTSD symptoms [B = −0.11, 95% CI (−0.18 to −0.04), p < 0.01] and depressive symptoms [B = −0.06, 95% CI (−0.10 to −0.01), p < 0.05]; while a buffering effect of vertical cohesion was observed for PTSD symptoms only [B = −0.03, 95% CI (−0.06 to −0.0001), p < 0.05]. At the unit-level, buffering effects of horizontal (but not vertical) cohesion were observed for PTSD symptoms [B = −0.91, 90% CI (−1.70 to −0.11), p = 0.06], depressive symptoms [B = −0.83, 90% CI (−1.24 to −0.41), p < 0.01], and suicidal ideation [B = −0.32, 90% CI (−0.62 to −0.01), p = 0.08].
Policies and interventions that enhance horizontal cohesion may protect combat-exposed units against post-deployment mental health problems. Efforts to support individual soldiers who report low levels of horizontal or vertical cohesion may also yield mental health benefits.
The sources and fate of radiocarbon (14C) in the Dead Sea hypersaline solution are evaluated with 14C measurements in organic debris and primary aragonite collected from exposures of the Holocene Ze’elim Formation. The reservoir age (RA) is defined as the difference between the radiocarbon age of the aragonite at time of its precipitation (representing lakeʼs dissolved inorganic carbon [DIC]) and the age of contemporaneous organic debris (representing atmospheric radiocarbon). Evaluation of the data for the past 6000 yr from Dead Sea sediments reveal that the lakeʼs RA decreased from 2890 yr at 6 cal kyr BP to 2300 yr at present. The RA lies at ~2400 yr during the past 3000 yr, when the lake was characterized by continuous deposition of primary aragonite, which implies a continuous supply of freshwater-bicarbonate into the lake. This process reflects the overall stability of the hydrological-climate conditions in the lakeʼs watershed during the late Holocene where bicarbonate originated from dissolution of the surface cover in the watershed that was transported to the Dead Sea by the freshwater runoff. An excellent correlation (R2=0.98) exists between aragonite ages and contemporaneous organic debris, allowing the estimation of ages of various primary deposits where organic debris are not available.
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.
Good education requires student experiences that deliver lessons about practice as well as theory and that encourage students to work for the public good—especially in the operation of democratic institutions (Dewey 1923; Dewy 1938). We report on an evaluation of the pedagogical value of a research project involving 23 colleges and universities across the country. Faculty trained and supervised students who observed polling places in the 2016 General Election. Our findings indicate that this was a valuable learning experience in both the short and long terms. Students found their experiences to be valuable and reported learning generally and specifically related to course material. Postelection, they also felt more knowledgeable about election science topics, voting behavior, and research methods. Students reported interest in participating in similar research in the future, would recommend other students to do so, and expressed interest in more learning and research about the topics central to their experience. Our results suggest that participants appreciated the importance of elections and their study. Collectively, the participating students are engaged and efficacious—essential qualities of citizens in a democracy.
Pascal Dusapin is a French intellectual – he cites the philosopher Gilles Deleuze as a particular inspiration – whose generation (he was born just a few months before Michel Houellebecq) are now to the fore following the death of Pierre Boulez. A student of Xenakis in Paris, he sometimes gives the titles of his works a linguistic quirkiness, as in for example, Ici, Iti, Incisa and Indeed. His comment on Outscape, his second cello concerto, that ‘it's difficult for me to explain my work because the substance of thought is confused with the flow of music’ is – given his musical pedigree and cultural milieu – unsurprising.
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.
(England gave me birth, France taught me, Sicily Cherished me; to it finally I gave my body and bones.)
From the mid-twelfth to the end of the thirteenth century the five reigning queens of England were Eleanor of Aquitaine, Berengaria of Navarre, Isabella of Angouleme, Eleanor of Provence and Eleanor of Castile.
Since the conference invites a double-crossing between nations and disciplines, France/England; History/Literature, I want first to raise a number of theoretical questions regarding ways of understanding place and the nation specifically as they pertain to England in the twelfth and early thirteenth centuries. I will then consider two kinds of illustrative material, one literary and the other more properly historical. The questions under discussion here are for me inescapably inflected by our own current geopolitical circumstances in which whatever the nation is or signifies is, if not in a state of utter emergency, then certainly under great stress among the designs of cross-border and non-state actors, internal questions of governmentality and the all-pervasive contemporary triumph of global capital.
In the twelfth century we can find in both secular and theological realms of thought a set of strictly speaking imaginary constructions that have had important consequences for the whole course of the historiography of state formation or nation building. Their common property is that they serve to provide a material embodiment for an ideal or symbolic entity. For example, the genealogical reduction of Continental families into a male bloodline and the corollary emergence of varieties of social coercion, such as primogeniture, to guarantee the concentration of property create a nexus of time, space and land based on blood, where blood is conceived as a material entity handed in an orderly succession from one generation to the next. Similarly, the debate over the nature of the Eucharist is resolved in the assertion that it is the real presence as well as its sign, just as the miracle working body of the high-medieval saint, whose sanctity consists almost entirely in the fact that the post-mortem body works miracles, becomes both the sign of redemption and its means. What unites these examples is their imaginary materiality.
Julian Anderson has been interestingly public about the genesis of his new orchestral piece Incantesimi, co-commissioned by the Royal Philharmonic Society, Berliner Philharmoniker Foundation and Boston Symphony Orchestra, writing about its genesis in The Guardian as a trailer to its UK Proms premiere. Premiered by the Berlin Philharmonic under Simon Rattle in June 2016, Incantesimi toured to Rotterdam and Lucerne before opening that orchestra's Prom (Rattle's last as their chief conductor) in September. Wanting not to write a ‘showpiece’ but instead ‘something slow and quiet’, Anderson described Incantesimi as a ‘nocturne’ which takes its musical inspiration from Mozart's Jupiter Symphony, in that five themes are deployed ‘in perpetual orbit’. He also spoke of his focus on the Berlin Philharmonic's beauty of sound as a prompt to write something that would unfold slowly.
Jörg Widmann is a German composer who is acutely conscious but certainly not in awe of his musical forebears. His best-known string quartet, no. 3 ‘The Hunt’ makes dramatic use of – and has great fun with – Schumann. His 2011 concerto Flûte en suite, performed at the 2014 Proms, more than nods to Bach and baroque elegance. In Armonica, commissioned by the International Mozarteum Foundation to celebrate Mozart's 251st birthday in 2007, Widmann surprisingly and yet unsurprisingly features the glass harmonica, the distinctive instrument that Mozart featured in his own last chamber piece, the Adagio and Rondo for glass harmonica, flute, oboe, viola and cello, K617. Mozart teamed the instrument with the quieter representatives from the wind and string families; Widmann places it against the whole orchestra.
In this article, we evaluate the usefulness of Google Consumer Surveys (GCS) as a low-cost tool for doing rigorous social scientific work. We find that its relative strengths and weaknesses make it most useful to researchers who attempt to identify causality through randomization to treatment groups rather than selection on observables. This finding stems, in part, from the fact that the real cost advantage of GCS over other alternatives is limited to short surveys with a small number of questions. Based on our replication of four canonical social scientific experiments and one study of treatment heterogeneity, we find that the platform can be used effectively to achieve balance across treatment groups, explore treatment heterogeneity, include manipulation checks, and that the provided inferred demographics may be sufficiently sound for weighting and explorations of heterogeneity. Crucially, we successfully managed to replicate the usual directional finding in each experiment. Overall, GCS is likely to be a useful platform for survey experimentalists.
‘Old mythologies’ have been important for some time to Anna Clyne, and they come into play again in two of her most recent works: the violin concerto The Seamstress and her brief Auden setting, This Lunar Beauty, for soprano and ensemble. The young British composer (b. 1980) has for many years been a resident of New York; she studied with Julia Wolfe in Manhattan and since 2010 has been the composer in association with the Chicago Symphony Orchestra.
‘Love poems are the best things to make song cycles out of’, Hugh Wood claimed in a pre-Prom interview. Wood's affection for English poetry dates back a long way: Scenes from Comus, his Milton setting premiered at the Proms in 1965 set his career going.
James MacMillan's new St Luke Passion is unusual. No longer does the Passion story end in the death of its principal character; there's a postlude that sees Christ resurrected. Neither is it peopled with singers acting out the traditional confrontations between Christ, Pilate and the High Priest; it starts instead with a brief setting of the Annunciation text found at the opening of St Luke's gospel. Unusual too is the small size of the orchestra – no trombones or tubas, one set of timpani as the sole percussion and an organ. Perhaps most surprising, however, is that the roles of Christus and Pilate, and indeed everyone else, are given to the choruses: a children's chorus for Christ, the other choirs acting as narrator.
Brett Dean's interests in writing his new cantata The Last Days of Socrates were both political and sonic. Coming across an old edition of philosophical dialogues by Plato with this title, the composer was taken particularly by The Apology in which Socrates's trial on a charge of ‘being a menace to society’ is dramatically recounted. Following his condemnation to death by the 501-person jury, the last dialogue in the collection Phaedo revisits Socrates in prison awaiting execution. Dean certainly has form both as a politically motivated composer – his Pastoral Symphony (2000) was a protest against the soullessness of modern living – and one with an interest in blending ancient and modern. One of his breakthrough pieces, Carlo (1997), pits sampled Gesualdo against strings to wonderful effect.
How many flutes are there in Simon Holt's flute concerto Morpheus Wakes? Nominally one, here the amazing Emanuel Pahud, but more usefully two or more. Scored for alto as well as standard flute, Holt exploits the timbral possibilities of both while ensuring that the orchestra's own flautist (doubling bass flute) and alto flautist (doubling piccolo) continue the idea of ‘two-in-one’ so central to his other recent concerto Centauromachy for clarinet, flugelhorn and orchestra written in 2010 and given its London premiere at the 2011 Proms.
It's not the premiere of every Polish symphony that's greeted by a near sell-out audience at the Royal Festival Hall, but then it's not every composer whose previous symphony had the success of Henryk Górecki's Third, his Symphony of Sorrowful Songs. The Upshaw/London Sinfonietta/Zinman recording of this work has sold over a million copies.
Americans are changing in terms of when and where they vote. We endeavor to find out whether these changes have affected the voting experience. Americans offer myriad reasons for not voting (Current Population Survey [CPS] 2004, 2006, 2008, 2010). Most of these excuses are beyond immediate remedy. There may be one exception: the way we conduct and administer our elections. Voting place practices have undergone considerable change in the last decade and may offer the most immediate if not direct means of enhancing the voters’ experience at their polling places and possibly voter participation. In this chapter, we ask whether contemporary polling place practices are related to the experiences voters have when voting and whether these practices directly or through voter experiences and other covariates have a nontrivial and appreciable effect on the likelihood of voting.
Our thesis is that when and where voters cast their ballot significantly impact the voter’s experience and the likelihood an eligible voter will actually vote. We find that when voters have a choice of where and when to vote rather than being limited to voting on one day and at a location most proximate to their residence, they are more likely to report a positive voting experience and are more likely to vote. Specifically we find that voters who cast a ballot before Election Day report a more positive voting experience than Election Day voters. Further we find that voters report more favorable voting experiences when they vote in larger voting places – voting places that are more centrally located, where voters work, shop, recreate, and travel, and that have accessible parking, a large number of voting stations, and a large number of poll workers.